Robots Do Better Than Surgeons

Robot-assisted surgery used to perform bladder cancer removal enables patients to recover far more quickly and spend significantly (20 per cent) less time in hospital, concludes a first-of-its kind clinical trial led by scientists at UCL and the University of Sheffield. The study, published in JAMA  also found robotic surgery reduced the chance of readmission by half (52 per cent), and revealed a “striking” four-fold (77 per cent) reduction in prevalence of blood clots (deep vein thrombus & pulmonary emboli) – a significant cause of health decline and morbidity – when compared to patients who had open surgery.  Patients’ physical activity – assessed by daily steps tracked on a wearable smart sensorstamina and quality of life also increased.

Unlike open surgery, where a surgeon works directly on a patient and involves large incisions in the skin and muscle, robot-assisted surgery allows surgeons to guide minimally invasive instruments remotely using a console and aided by 3D view. It is currently only available in a small number of UK hospitals. esearchers say the findings provide the strongest evidence so far of the patient benefit of robot-assisted surgery and are now urging National Institute of Clinical Excellence (NICE) to make it available as a clinical option across the UK for all major abdominal surgeries including colorectal, gastro-intestinal, and gynaecological.

Co-Chief Investigator, Professor John Kelly, Professor of Uro-Oncology at UCL’s Division of Surgery & Interventional Science and consultant surgeon at University College London Hospitals, said: “Despite robot-assisted surgery becoming more widely available, there has been no significant clinical evaluation of its overall benefit to patients’ recovery. In this study we wanted to establish if robot-assisted surgery, when compared to open surgery, reduced time spent in hospital, reduced readmissions, and led to better levels of fitness and quality of life; on all counts this was shown. “An unexpected finding was the striking reduction in blood clots in patients receiving robotic surgery; this indicates a safe surgery with patients benefiting from far fewer complications, early mobilisation and a quicker return to normal life”, explained Co-Chief Investigator, Professor John Kelly, Professor of Uro-Oncology at UCL.

Co-Chief Investigator Professor James Catto, Professor of Urological Surgery at the University of Sheffield, added: “This is an important finding. Time in hospital is reduced and recovery is faster when using this advanced surgery. “Ultimately, this will reduce bed pressures on the NHS and allow patients to return home more quickly. We see fewer complications from the improved mobility and less time spent in bed. “The study also points to future trends in healthcare. Soon, we may be able to monitor recovery after discharge, to find those developing problems. It is possible that tracking walking levels would highlight those who need a district nurse visit or perhaps a check-up sooner in the hospital.”“Previous trials of robotic surgery have focused on longer term outcomes. They have shown similar cancer cure rates and similar levels of long term recovery after surgery. None have looked at differences in the immediate days and weeks after surgery.”

Source: https://www.ucl.ac.uk/

How To Kill Antibiotic-Resistant SuperBugs

A new compound which visualises and kills antibiotic-resistant superbugs has been discovered by scientists at the University of Sheffield and Rutherford Appleton Laboratory (RAL). The team, led by Professor Jim Thomas, from the University of Sheffield’s Department of Chemistry, is testing new compounds developed by his PhD student Kirsty Smitten on antibiotic resistant gram-negative bacteria, including pathogenic E. coli.

Gram-negative bacteria strains can cause infections including pneumonia, urinary tract infections and bloodstream infections. They are difficult to treat as the cell wall of the bacteria prevents drugs from getting into the microbeAntimicrobial resistance is already responsible for 25,000 deaths in the EU each year, and unless this rapidly emerging threat is addressed, it’s estimated by 2050 more than 10 million people could die every year due to antibiotic resistant infections. Doctors have not had a new treatment for gram-negative bacteria in the last 50 years, and no potential drugs have entered clinical trials since 2010.

The new drug compound has a range of exciting opportunities. As Professor Jim Thomas explains: “As the compound is luminescent it glows when exposed to light. This means the uptake and effect on bacteria can be followed by the advanced microscope techniques available at RAL.

Gram negative bacteria. Credit: University of Sheffield

“As the compound is luminescent it glows when exposed to light. This means the uptake and effect on bacteria can be followed by the advanced microscope techniques available at RAL“, explains Professor Jim Thomas. This breakthrough could lead to vital new treatments to life-threatening superbugs and the growing risk posed by antimicrobial resistance.”

The studies at Sheffield and RAL have shown the compound seems to have several modes of action, making it more difficult for resistance to emerge in the bacteria. The next step of the research will be to test it against other multi-resistant bacteria.

Source: https://www.sheffield.ac.uk/

How To Measure The NanoWorld

A worldwide study involving 20 laboratories has established and standardized a method to measure exact distances within individual biomolecules, down to the scale of one millionth of the width of a human hair. The new method represents a major improvement of a technology called single-molecule FRET (Förster Resonance Energy Transfer), in which the movement and interaction of fluorescently labelled molecules can be monitored in real time even in living cells. So far, the technology has mainly been used to report changes in relative distances – for instance, whether the molecules moved closer together or farther apart. Prof. Dr. Thorsten Hugel of the Institute of Physical Chemistry (University of Freiburg) in Germany is one of the lead scientists of the study, which was recently published in Nature MethodsFRET works similarly to proximity sensors in cars: the closer the object is, the louder or more frequent the beeps become. Instead of relying on acoustics, FRET is based on proximity-dependent changes in the fluorescent light emitted from two dyes and is detected by sensitive microscopes. The technology has revolutionised the analysis of the movement and interactions of biomolecules in living cells.

Hugel and colleagues envisioned that once a FRET standard had been established, unknown distances could be determined with high confidence. By working together, the 20 laboratories involved in the study refined the method in such a way that scientists using different microscopes and analysis software obtained the same distances, even in the sub-nanometer range.

The absolute distance information that can be acquired with this method now enables us to accurately assign conformations in dynamic biomolecules, or even to determine their structures”, says Thorsten Hugel, who headed the study together with Dr. Tim Craggs (University of Sheffield/Great-Britain), Prof. Dr. Claus Seidel (University of Düsseldorf) and Prof. Dr. Jens Michaelis (University of Ulm). Such dynamic structural information will yield a better understanding of the molecular machines and processes that are the basis of life.

Source: https://www.pr.uni-freiburg.de/