A world-first surgical technique, developed and performed exclusively by three surgeons at Lancashire Teaching Hospitals NHS Foundation Trust, is attracting the attention of colleagues in Europe and America.
Consultant colorectal surgeons Mr Tarek Hany, Ms Alka Jadav and Mr Arnab Bhowmick reached a major milestone in June last year as they completed 100 cases of Extra-Peritoneal Colorectal Surgery (EXPERTS) - a ground-breaking approach pioneered at the Trust, marking a significant achievement in the advancement of minimally invasive colorectal surgery.
The EXPERTS technique avoids puncturing the peritoneum - the membrane surrounding abdominal organs - by accessing the surgical site from beneath the bowel. This innovative method improves patient safety and recovery, reduces the risk of injury to surrounding organs, and eliminates the need for awkward patient positioning.
To support training and global dissemination, the Trust has developed bespoke 3D animation and virtual reality tools, which are now gaining attention from surgical teams across Europe and the United States.
Recently, the surgical team welcomed Dr Antonio Caycedo-Marulanda, a leading colorectal surgeon based in Orlando, Florida, who flew in especially to observe the EXPERTS technique in action. His visit marks the start of an exciting international collaboration on single-port extra-peritoneal (XP) surgery.
Mr Hany said: “We met Antonio at a conference in the US where we were presenting this work. He was so enthusiastic that he arranged to travel across the Atlantic to see the operation first-hand.
"It’s testament to his vision and leadership. He’s already begun applying the principles in his own practice back in Florida.”
Mr Hany live telementored Dr Caycedo-Marulanda's first case of EXPERTS procedure using the unique single port robot, which was a successful operation, as he said: "I was pleased to be able to help my colleague to successfully perform the procedure."
Dr Caycedo-Marulanda’s visit reflects growing global interest in the EXPERTS approach, which is already showing benefits such as shorter time to bowel function recovery, reduced hospital stays, lower incidence of ileus (gut paralysis), no significant intra-abdominal injuries and fewer conversions to open surgery.
Performed with the patient in a supine (face-up) position - rather than the traditional head-down tilt - the method also reduces risks such as compartment syndrome, lung and eye pressure, and shoulder injuries.
International interest continues to grow. Mr Hany and his colleagues are collaborating with surgeons in Alicante, Spain, to demonstrate the procedure in cadavers. The team is also preparing to welcome surgeons from Italy and Malaysia who wish to observe the technique in practice.
Initially trialled on cadavers in 2018, the first live case was performed in February 2020. It has since won recognition at major conferences, including the Portsmouth Colorectal Congress and the European Society of Coloproctology (ESCP) in Thessaloniki, Greece.
Mr Hany believes the surgery can be further enhanced: “We’ve had fantastic support from the Trust, and this is just the beginning. We are working hard to acquire the state-of-the-art robotic platform which will transform cancer surgery for our patient population."
Last month, Mr Hany was at the European Society of Coloproctology (ESCP) 20th Scientific and Annual Conference in Paris at the Palais des Congrès de Paris, which brought together leading experts, clinicians, researchers, and industry professionals in the field of colorectal surgery and care.
There he met surgeons from Sechenov Hospital in Moscow as well as Laparoscopic General and Colorectal Surgeon Mr Najam Husain from Derby and Colorectal Surgeon Muhammad Abdalkoddus from Plymouth as they look to establish collaboration on the EXPERTS Procedure and establish standardisation of the technique.
