Robotic surgery delivering ‘game-changing’ care for children in Manchester

A four-month-old baby boy is the youngest child in the world to successfully have surgery using the Versius Surgical System, which his surgeons call a “game-changer” for reconstructive surgery. 

The operation to remove part of a narrow kidney tube, was carried out at Royal Manchester Children’s Hospital (RMCH), part of Manchester University NHS Foundation Trust (MFT), in a clinical study on the use of Versius in paediatric surgery. 

Surgeons are excited about the new possibilities for paediatric surgery as its 5mm wristed instruments offer increased precision, making operations less invasive and helping to support faster recovery times in patients. 

Baby Mohammed, who lives in Manchester weighed just six kilogrammes, when he underwent a pyeloplasty operation; surgery to treat a narrow ureter (the tube that connects each kidney to the bladder).  

Mohammed was born with a narrow ureter which was stopping the urine made by his kidney from draining properly down towards his bladder. This caused him to have severe urine infections as a baby and if not treated, could have resulted in him losing his kidney function entirely.  

Pyeloplasty surgery aims to restore the drainage of the kidney, prevent urine infections and in older children, is a cure to episodes of severe pain called Dietl’s crisis, which can occur with this condition. 

Mohammed’s Mum, Mariam said: “As parents we were worried about Mohammed’s narrow ureter because of the risks of him getting infections which could damage his kidneys.   

“We didn’t think it would be possible for him to have the surgery needed to fix the problem at just four months old. We thought that he would be too small. It was a huge relief when we found out that he wouldn’t have to wait because doctors can operate so precisely using the robotic system.   

“Mohammed was back home just three days after the surgery and he’s doing great. Of course, his health is the most important, but as parents you worry about everything. With this surgery we’re really grateful that there is minimal scarring.  

“We are so glad we took part in this study. The doctors were amazing and really instilled confidence in us. They talked us through the whole thing and went above and beyond to make sure we were comfortable with the procedure.  

“I would absolutely encourage others to be part of this research. I believe this development will be revolutionary in the care for everyone, but especially young children because it allows issues to be targeted early, before problems can get worse.”  

At RMCH, the Children’s Urology Team perform between 125 and 150 complex reconstructive surgeries per year, such as pyeloplasty which may show benefits from being performed robotically. 

Versius can also make complex operations less physically demanding for surgeons. This has the potential to reduce strain on surgical teams, allowing a greater number of complex surgeries to be carried out each day.  

In Manchester, the team has started to do two cases per day when previously only one surgery would be carried out per day.  

10-year-old Harry also recently underwent robotic pyeloplasty surgery using Versius. He was experiencing severe abdominal pain due to a blockage in the tube from his kidney to his bladder (ureter) which was being compressed by a crossing blood vessel. Harry was able to return home in three days following surgery at RMCH.   

Mr Keene, Consultant Paediatric Urology Surgeon at RMCH said: “This is exciting because the level of precision of the robotic surgery is much higher compared to standard key-hole surgery and recovery is improved compared to open surgery without compromising the success of the surgery. 

“Typically older children who have bladder or kidney surgery stay in hospital for up to seven days. With surgery using the Versius Surgical System, which is less invasive, they have recovered enough to return home in just two to three days.  

“This new generation of surgical robots is particularly suited to the complex reconstructive surgery undertaken in childhood where the structures are smaller and precision is paramount. 

“Since August 2024, the Manchester Children’s Robotic Team has successfully carried out 25 robotic operations including 12 pyeloplasties at MFT and three other types of complex bladder surgeries as part of the study.” 

Created by UK company CMR Surgical, Versius consists of up to four modular arms that are designed to mimic human joints and is controlled by the surgeon sitting in the same room as the patient. The robotic system translates any movements made by the surgeon on an open console into smaller, more precise motions in the robot’s miniature instruments. 

Miss Toli Onon, Joint Chief Medical Officer at MFT, said: “We are delighted to be part of this exciting research. Robotic assisted surgery is transforming patient experience and clinical outcomes and has been successfully used in adult surgery for many years.  

“Being able to deliver this revolutionary technique to such a young patient paves the way for increasingly complex surgery in many more babies and children.” 

MFT is one of three sites taking part in the study, aiming to recruit 60 to 70 patients. Other sites in England include Southampton Children’s Hospital, and Evelina London Children’s Hospital, part of Guy’s and St Thomas’ NHS Foundation Trust.   

The study will initially use Versius to undertake a range of urological (urinary tract) procedures in 150 paediatric patients across the UK, before assessing its potential use for a wider range of conditions.