Robotic surgery linked to improved outcomes in Limerick study

• Annual NCHD Research Conference at University Hospital Limerick sees record interest from researchers
• Overall winner Dr Taya Keating highlights benefits of robotic surgery in colorectal patients

Patients who undergo robotic colorectal surgery benefit from reduced post-operative inflammation and tissue trauma, attendees at an academic conference in Limerick have heard.

Dr Taya Keating presented the winning paper at the annual NCHD Research Conference at University Hospital Limerick (UHL), a showcase of research activity, audit and quality improvement initiatives completed by non-consultant hospital doctors working and training in the Mid West region.

Dr Keating is currently a general and colorectal surgery SHO at UHL, one of the country’s leading centres for robotic colorectal surgery. Since the establishment of its robotic programme in 2016, approximately 400 patients have had robotic colorectal procedures at UHL.

Robotic surgery is widely considered the international gold standard and is associated with improved patient outcomes and shorter recovery times. And the development of a robotic surgery programme at UHL and St John’s – now including colorectal, urology, gynaecology and general surgery - has made the Mid West a more attractive place for surgeons to work and train.

Dr Keating and colleagues’ winning research was a systematic review and meta-analysis that compared post-operative markers of inflammation in colorectal patients who had undergone either robotic or laparoscopic (traditional keyhole) surgery. 

Eight prior studies involving 1,706 patients were included in the review. While both robotic and laparoscopic procedures are considered minimally invasive, the analysis showed that the enhanced precision of the robotic approach showed clear benefits with reduced tissue trauma and post-operative inflammation. The analysis found in particular that CRP (C-reactive protein) levels, a surrogate marker for inflammation, were significantly lower post-operatively in patients who had undergone robotic as opposed to laparoscopic procedures. Dr Keating explained:

“The high-definition 3D camera is superior in terms of visualisation and depth perception, in comparison with the conventional 2D laparoscopic camera. The surgeon can control all four arms from the robotic console and so these systems offer improved dexterity and precision. This aids in reducing tissue handling thus minimising local tissue stress and inflammation. These advantages translate into meaningful clinical benefits, including less postoperative pain, shorter hospitalisation, and fewer complications, compared with the laparoscopic approach,” she added.

Now in its sixth year, the annual conference was initiated by Lead NCHDs at UHL in partnership with the Postgraduate Medical Education & Training Office, under the leadership of Regional Director Postgraduate Medical Education & Training, Prof John McManus.

A record 258 abstracts were received for this year’s conference, an increase of 13% from last year. Abstracts were received from various disciplines including anaesthetics, emergency medicine, medicine, surgery, paediatrics, psychiatry, obstetrics and gynaecology, radiology, the Intern Network, general practice and public health.

Among the specialty winners this year were research projects on insulin pump therapy and socioeconomic background; ambulatory cellulitis management; quality of life of patients on dialysis; primary care prescribing patterns for GLP-1 medicines (e.g. Ozempic); and peri‑menopausal and menopausal symptoms in women with enduring severe mental illness. This year’s winners and abstracts also reflected the growing interest in the role of artificial intelligence in clinical research and decision-making.

Keynote speaker at this year’s conference was Prof Dara Byrne, HSE National Clinical Lead for Simulation, who also participated in a clinical skills simulation for NCHDs on the day of the conference.

Speaking on the success of the conference, Prof Margaret O’Connor, Deputy Regional Clinical Director, Education Training & Research HSE Mid West said: “I extend huge congratulations on this year’s NCHD Conference, which achieved record attendance, record engagement with abstract submissions, and publication of the top 80 abstracts in the Irish Journal of Medical Science. The simulation workshops and Professor Dara Byrne’s keynote - on simulation and improving patient and system safety - were key highlights. This work is central to bringing research into clinical practice and promoting better care for patients. My sincere thanks to Mairead de Brún and Bryan Dunne from the Training Lead Office for their excellent organisation, and to Professor John McManus, Alan Watts and the Training Lead Team for their leadership and commitment.”