Royal Surrey NHS Foundation Trust

Jay Chatterjee

I did my general Obstetrics and Gynaecology training in many of the prestigious hospitals in London. I subsequently did my sub-specialist fellowship training in Gynaeoncology surgery, at the world-renowned West London Gynaeoncology Cancer centre at the Hammersmith Hospital in London. This was and continues to be one of the largest gynaecological cancer centres in the United Kingdom. Before embarking on my sub-specialist training, I completed my doctoral studies looking at a novel immune pathway in ovarian cancer at Imperial College, London.

I was head hunted and appointed as a sub-specialist Gynae-oncology full-time substantive consultant at the Royal Surrey County Hospital NHS Foundation trust in 2015. I subsequently set up our academic department establishing strong research and academic ties with University of Surrey, Imperial College, London and Brunel University, London. My passion and enthusiasm in education and training stimulated me to take on the role as the training program director for Gynaeoncology surgery in the region and nationally.

Patient outcomes and patient safety, continue to be the guiding factors in my outlook at integrating any innovation into clinical practice. Robotic surgery naturally lends itself to this. Since the introduction of the robotic program in our department, we have consistently shown an improvement in patient outcomes, evidenced by looking at conversion rates, length of stay, complication rates and oncological outcomes. These measures and outcomes need to be robustly collected prospectively in a departmental database, so that the findings can be analysed at regular intervals to benchmark performance indicators.

“Patient outcomes and patient safety, continue to be the guiding factors in my outlook at integrating any innovation into clinical practice.”

There are broadly two main barriers to universal adoption of robotic surgery in gynaecological oncology. The first barrier is the high cost of implementation of the program due to the expense relating to the consumables. Secondly and more importantly, there is a lack of a structured training program for surgeons to safely be able to adopt this surgical platform. As with any new technology, the cost of this advanced surgical platform is expected to decrease over time.

That being said, most countries need to adopt a structured training program which encourages and supports life-long surgical learning and takes into account the learning curve of a surgeon learning a new technology. At the same time, the program should integrate these new technologies in the core training modules for upcoming surgeons.

Balancing the needs of patient safety and introducing a new technology is always a clinical challenge. However, the implementation of such surgical techniques is based on robust foundations of research, evaluating the evidence and data and using strong training platforms for carefully selecting the right surgeons as the pioneers for such surgeries. Coordinating the seamless journey from the initial idea to implementation of the surgical pathway, and then evaluating the outcomes, completes the bench to bed translation.

One of the foremost principles I follow as a clinical leader is implementation of flat hierarchy, where every team member feels empowered to bring improvement to the team. I feel privileged to lead a team of colleagues who are continuously pushing the boundaries of clinical excellence to improve patient care and outcomes. I feel it is my duty as the clinical director, to support my colleagues in their growth and encourage them to bring about positive changes to the department through engagement involving debates, audits, research and rigorous interrogation of clinical evidence for betterment of our patients.

I feel humbled in answering this question. I strongly feel if we put the patient as the first and foremost priority in our search for clinical excellence and thereby legacy, we would create an environment which stimulates knowledge and improve patient outcomes in gynaeoncology.