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A surgeon in Seattle ‘virtually scrubbed-in’ to a live procedure in London to help save an NHS patient’s life

Proximie, the UK technology platform, enabled two surgeons 4,700 miles apart to virtually collaborate during a pioneering robot-assisted, retroperitoneal lymph node testicular cancer procedure on an NHS patient.

The five hour robotic operation, carried out at the cancer centre at Guy’s Hospital on May 21, involved Archie Fernando [pictured above during the live procedure], consultant urologist at Guy’s and St Thomas’s NHS Foundation Trust, extracting a 5cm tumour attached to two major blood vessels in the abdomen of patient Mo Tajer, from West Hampstead, London.

Virtually attending the operation in the US, was Dr. Jim Porter, medical director for robotic surgery at the Swedish Medical Centre in Seattle, and one of the world’s leading laparoscopic surgeons. From his home, and with the help of Proximie, he was able to remotely and virtually reach into Fernando’s field of vision to assist her during the surgery in real-time.

Proximie’s unique combination of machine learning, artificial intelligence and augmented reality, enabled Porter to support Fernando through each precise incision, with no lags or delays, and using just his laptop and a web-cam. Both surgeons were able to communicate audibly and visually via the live video feed, and remotely interact in the procedure, in a visually, intuitive and immersive way. Porter was able to provide verbal instructions, draw and overlay important directions, and virtually reach into Fernando’s clinical field to provide precise guidance, despite being a continent apart and an eight hour time zone behind.

Fernando explains: “We had always intended to seek Jim Porter’s opinion on this case prior to operating and had actually planned to fly out to Seattle to discuss the procedure, but the obvious travel restrictions due to COVID-19 prevented us from doing so.”

With resources being channelled into supporting the influx of COVID-19 patients, Fernando and her colleague Ben Challacombe, the team from Guys’ leading urological cancer and clinical robotics centre, which do the most robotic cases in the UK, opted for the virtual consultation with Porter using Proximie, and a private operating room at Guy’s cancer centre.

“It was like having Jim present in the operating room,” Fernando says. “He had the same viewpoint as me and he and I could talk and virtually interact.”

She continues: “The successful operation on Mo, who is someone I have got to know well, is an incredible testament to the power of surgical collaboration and the state of the art technology that helped to facilitate it. I really believe that this unique combination can help more patients receive the best possible care in the future.”

Porter says: “Proximie enabled Archie and I to collaborate and share expertise in real-time that would otherwise not be possible. COVID-19 has been a catalyst for the rapid adoption of new innovations and I believe this technology could be another exciting new chapter in the future of clinical collaboration.”

Tajer, who had a large tumour removed from his aorta and inferior vena cava, says: “I studied biochemistry at university and did a master’s that involved cancer-related research, but I never thought I would find myself at the epicentre of this next-generation surgical cancer treatment!”

“I’m so grateful to Archie and her team at the NHS, and to the innovation that enabled it to happen. I would also like to thank my girlfriend, who insisted on me seeking medical attention.”

In the last month Proximie, which was founded by Dr. Nadine Hachach-Haram FRCS (Plast), BEM, Consultant Plastic Surgeon and Head of Clinical Innovation at Guy’s and St. Thomas’ NHS Foundation Trust, has been used by a number of NHS sites, as the country has scrambled to stop the pandemic.

“I’m incredibly proud that this pioneering operation could go ahead and that Proximie could be used to connect such skilled surgeons from so far away,” Dr. Hachah-Haram explains.

“COVID-19 is going to have a profound and lasting impact on the future of healthcare and how we practice, but by incorporating integrated technologies like Proximie into routine or complex procedures, we have shown that we can seamlessly maximise healthcare resources, scale the delivery of expertise, reduce transmission of the virus, and ultimately ensure that every single patient has access to the best possible care, regardless of where they are in the world.”

Originally designed for surgeons, Proximie is tailored made for austere environments, and is already being deployed by the Ministry of Defence to improve front line trauma surgery and save lives. The platform is built for the COVID-19 type crisis, being secure, accessible, easily integrated and working at low bandwidth, with existing or easy to resource hardware. The platform is deployed in over 50 hospitals around the globe, completing more than 300 surgeries each month, in 30 countries.