As part of the hospital’s robotics programme Reza regularly uses the Da Vinci Xi surgical robot to operate on patients with cancers and other conditions of the bowel and rectum. Reza invited us to join him on a standard day at work at the hospital.
Day in the life: Reza Mirnezami consultant surgeon
Go behind the scenes and experience a typical day treating patients using the da Vinci Xi surgical robot at the Royal Free Hospital.
Mr Reza Mirnezami FRCS PhD is the clinical director for colorectal, general and emergency surgery at the Royal Free Hospital.
6am
Get up, get ready and head to Hampstead.
During the drive I’ll have a mental dress rehearsal for what’s coming. Work features in my thoughts all through the day and sometimes at night too, I’ll be trying to sleep and planning an operative approach. I usually play music with a bit of a beat to get me in the zone for the day.
7am
Park at Royal Free Hospital. Grab an americano in the hospital.
7.15am
Meet with the senior surgical team, discuss today’s surgeries, check scans and notes.
“We aim to perform two major surgeries a day but that varies according to the complexity of each case.”
8.30am
Meet today’s patients in the ward.
I’ll explain where we’re going to access through the abdomen and go over their notes. Once we’ve got their consent and a phone number for a relative I can call after surgery, I head down to theatres – it’s usually no. 14 which houses the robot.
9am
Meet with the full surgical team to discuss the day’s operating strategy, while the lead theatre nurse preps the surgical robot and the anaesthesia team gets the patient ready.
That leaves us in a position where we know what the surgical plan is, what special equipment we’ll need and everything to do with the anaesthetic side of that patient’s theatre episode.
9.30am
Eat a bowl of porridge. I don’t want to be hungry during surgery.
10.30am
Surgery, first patient.
Major complex cases start around 10.30am. I’ll greet my team in theatre. Jason, who’s one of the scrub nurses, gets a high five, because he’s just that kind of guy. For sister Geraldine, who’s integral to everything we do, it’s ‘good morning, sister, how are you?’
“Everything’s ready, the robot is prepped wearing its protective coat, and we’re excited for the day. Although there’s seriousness to come, it’s a happy, friendly environment. Everyone’s focussed on what they need to do.”
After surgery we do a team debrief and I always call the patient’s family to let them know how it went.
If I have another surgery that day I’ll grab something healthy from the canteen.
2pm
Surgery, second patient.
I absolutely love using the surgical robotic system. As soon as the new robot had arrived, I was off to Freiburg in Germany for the manufacturer’s surgery training course. The facilities were fabulous.
We’d arranged for an operating list with one of the robot manufacturer’s proctors – a highly experienced clinician who oversees other clinicians training in a particular skill – for the two days following our return, which was great as everything was still fresh in our minds. We completed three proctored lists and were then signed off by the manufacturer’s surgeons, so by May we we’re independently using the robotic system – and it’s just a joy to use.
6pm
Debrief with the surgical team.
I’ll go and check on the patient in recovery, they’re usually in the high dependency unit straight after surgery.
7pm
Drive back home. I’ll listen to jazz, or a bit of Nina Simone, something calming.
Evening
I try to get to the gym three times a week, I love a workout followed by a sauna. Most evenings I’ll get home and start cooking dinner for the family. I really enjoy cooking, especially when I have a bit more time on the weekends – although my youngest is quite fussy!
“I might play a bit of Super Mario Kart with my two kids. My wife teases me when I tell her I’ve got to do it for work. My hand-eye coordination is pretty good!”
The surgical robot and me
“For my specialism of colorectal surgery, the surgical robotic system is a game-changer in three areas: precision, post operative recovery and post operative pain.
“The robot gives you tools and ways of doing things that would not be possible laparoscopically. For example, in a patient with a very narrow pelvis it’s very hard to operate because the anatomical space is so limited. But the robot has the dexterity and the range of movement and precision that allows you to dissect in those hard-to-reach spots.
“Using the robot for bowel surgery is a game-changer in terms of pain management and recovery too. Traditionally, we needed to make a long incision in order to take the bowel outside of the body, but now using the robot we make a small incision in the bikini line, so it’s not visible, there’s lower risk of infection, there’s no risk of a hernia – and crucially there’s far less pain.”
Starting out in medicine
“I became a doctor because I always wanted to have a vocation that would allow me to directly help people when they’re at their most vulnerable.
“Growing up, I’d seen my family help relatives with a range of health problems and they were often in and out of hospital. I was impressed back then by the professionalism that these individuals exuded – the doctors, the nurses and the whole environment.
“When I was around 11 years old I was fascinated by biology and I had an amazing picture book of science for kids which showed cells and body parts as cartoon characters. Then, my brother, who is eight years older than me, studied medicine at Southampton University and started coming home with all these highly detailed medical textbooks and I was gripped.
“He pursued a career in medicine and then ultimately surgery, and he was a very big influence on me. He’s an excellent big brother!”