1,000th robotic prostate cancer surgery procedure performed at the Lister

The team behind the Lister’s Hertfordshire and Bedfordshire Urological Cancer Centre, which opened in December 2008, has carried out its 1,000th prostatectomy procedure using robotic surgery.  This places the centre as one the largest services in the country.   The surgery carried out by the team also includes full and partial removal of kidney, bladder removal and reconstruction, as well as prostate cancer treatment.

Consultant urological surgeon and clinical director for Urology, Mr Jim Adshead, said:

“Here at the Lister, the urology team has always sought to provide services locally that in many parts of the country could only be found in major teaching hospitals.  Thanks to the generosity of benefactors Stef and Stelio Stefanou, we were the first district general hospital to offer robotic urological surgery.  Until very recently, we were the only centre in the country to be approved by the Royal College of Surgeons to train the next generation of urology consultants in robotic surgery.  To date we have helped to place six training fellows in substantive roles in hospitals around the world.”

Above: Picture of the 1st robotic prostate cancer surgery patient treated at the Lister, John Rouse (centre), and the 1,000th, Arthur Sadowski (second left) – along with the Trust’s clinical director for urology and consultant urological surgeon Mr Jim Adshead (furthest left), and fellow consultant urological surgeons Mr Tim Lane (second right) and Mr Nikhil Vasdev (furthest right). 


Traditional approaches to such prostate surgery can leave positive margins in around 25% of cases. This is can result in some cancer cells being left behind – leading to the need for further, often expensive treatments such as radiotherapy.  Based on work undertaken initially at Hamburg’s Martini Klinik four years ago, the Lister team uses a technique known as NeuroSAFE, where erection nerves close to the tumour are spared as the prostate gland is removed without risking a positive margin.

Mr Adshead explains:

“Currently the Lister team is the only centre in the country to offer robotic prostate surgery with NeuroSAFE – a technique to spare nerves around the prostate gland without compromising the cancer margin.  The procedure improves recovery of bladder and sexual function to world class levels.

“Working with our colleagues in the Lister’s pathology team, tests are undertaken whilst the patient is still on the operating table to ensure that the chances of positive margins existing are minimised.  Given that the national rate is around one quarter of patients having their prostate have a positive margin we are proud of our positive margin rate of only 7-8% of our cases.  So not only do our patients have a far better chance of getting their bladder and sexual functions back after surgery, far fewer will need further treatments such as chemotherapy and radiotherapy – which is better for them and less cost to the NHS.”

Today the Lister’s robotic prostate team of three urological consultants all perform and develop this NeuroSAFE technique – Jim Adshead, Tim Lane and Nikhil Vasdev – and their theatre team colleagues undertake virtually all their cancer surgery using robotic procedures. The prostate cancer margins are checked live by Dr Samita Agarwal and Dr Ashish Narula – the Trust’s expert uro-pathologists – while the patients are still anaesthetised.