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Surgeons have carried out the first ever robotic open-heart operations in Britain at the New Cross Hospital in Wolverhampton.

New Cross Hospital hopes to carry out 30 mitral valve repairs a year using the robot that is already employed in other operations at the hospital. The UK is the third country in Europe after Sweden and Finland to perform open-heart surgery using robots. Surgeons Moninder Bhabra and Mr Billing and their team underwent extensive training in Finland before the first procedure.

Snake Robot

A 30cm (1ft) snake slowly moves through the body of a man on a spotless table, advancing its way around the liver.

This is a medical robot, guided by a skilled surgeon and designed to get to places doctors are unable to reach without opening a patient up. It is still only a prototype and has not yet been used on real patients - only in the lab. But its designers, from OC Robotics in Bristol, are convinced that once ready and approved, it could help find and remove tumours. The mechanical snake is one of several groundbreaking cancer technologies showcased at this week's International Conference on Oncological Engineering at the University of Leeds.

Most of the devices are in very early trial stages, but Safia Danovi from Cancer Research UK says that innovation and research are extremely important in tackling the disease.

Training concerns in Robotic Surgery

Even supporters have concerns about training. Intuitive runs an intensive three-to-four-day course at its Sunnyvale, Calif., home, including cadaver work, and dispatches mentors to monitor trainees for several cases before certification. Then, it's up to the hospitals to set rules — and they're all over the map. Lenihan, MultiCare's medical director for robotics and minimally invasive surgery, said lawsuits by patients injured during robotic surgery increasingly allege that hospitals didn't properly train or credential surgeons. The lack of national standards has prompted some to argue for restricting robotic surgery to large, research-oriented medical centers. Curet says Intuitive found surgeons, after training, can operate robots safely in the first 25 cases, gaining speed with experience. "You're starting out safe, and just getting faster." But Lenihan recalls MultiCare's steep learning curve from 2005 to 2008. At first, MultiCare and other hospital systems pushed surgeons to use the pricey new tool, he said. By 2008, "We saw a big jump in the number of cases, and we also started to see a big jump in the number of complications." Urologists needed 200 to 250 cases to get "consistently good," he said, and even laparoscopy-savvy gynecologists took 50 to 100. Now, MultiCare and other large local centers, such as Swedish and the UW, require surgeons to train on simulation programs on the da Vinci or on a console called Mimic, which tests skills on lifelike video "tissues" that spurt blood when cut and smoke when burned. MultiCare, for example, also requires all surgeons to do at least 20 robotic surgeries a year to keep their robot-use credentials.