IT TAKES surgeons an hour and a half to remove the apple-sized tumour from their patient's intestine.

Hillary Ives is among the first people in the world to undergo an innovative type of keyhole surgery for bowel cancer being pioneered in Plymouth.

The technique involves inserting a telescopic camera and surgical instruments through one small incision near the belly button.

Surgeons cut free the tumour while watching their delicate work on screen — and then pull a section of bowel through the incision to finish their work.

The minimally invasive 'single-port' colorectal surgery may have benefits over traditional multi-port keyhole procedures, which use five incisions.

Keyhole surgery is faster and safer for many patients than open surgery, which involves much larger incisions.

It generally means a lower risk of infection, less scarring, faster recovery times and therefore shorter hospital stays. Patients are home in about three days rather than eight or more for open surgery.

Mark Coleman, colorectal consultant at the hospital, says: "Derriford Hospital has gone from doing just a little keyhole surgery 10 years ago to becoming a centre of excellence.

"It's a team effort, with myself and colleagues across many specialities making sure we didn't stay behind the rest of the world.

"We are pushing the frontiers of keyhole procedures — for example with this type of single port surgery.

"We've done 11 procedures and are one of the biggest centres in the world for this type of operation, which we are pioneering.

"The evidence we have is that it's been safe and effective."

Mr Coleman is also national clinical lead for the National Training Programme in Laparoscopic Colorectal Surgery.

Hillary arrived at Derriford Hospital at 7.30am yesterday. She was prepped, anaesthetised and unconscious on the operating table by 9.15am. Mr Coleman, assisted by colorectal surgeon Tom Edwards, makes the incision in her belly. They seal the port over the cut. It is a plug with five holes: one for the camera, two for surgical instruments and a further two for carbon dioxide lines.

The gas is used to inflate her belly, lifting the abdominal wall above the internal organs like a dome to create a working and viewing space.

A tiny camera, on a rod with a light attached, is inserted through the port and surgeons suddenly have a clear view inside Hillary's body.

Mr Coleman explains that the camera feed is showing her liver, gall bladder, stomach and colon. The tumour is in her large intestine. Shoulder to shoulder, the two surgeons cut free the section of bowel from the surrounding tissue and her appendix.

Much of the time Mr Edwards positions the camera while his colleague wields the other tools.

Mr Coleman uses an 'harmonic scalpel' — an amazing piece of ultrasonic kit which vibrates at 50,000 times a second. The intense heat created can cut and seal blood vessels at the same time.

A larger blood vessel is sealed with titanium staples.

Mr Coleman says: "We can feel a little calmer now as we've cut the blood supply to the tumour."

He adds that cutting the supply before removing the tumour is another pioneering technique which is not used anywhere else. He believes it can help stop the cancer from spreading.

At 10.05am, the instruments are removed and a section of intestine is brought outside Hillary's body through the initial incision, which needs to be widened slightly.

The next part of the operation takes place on her stomach. A surgical stapler — which cuts at the small time as firing out rows of tiny staples — is used to slice and seal the large intestine.

A 10-inch long section of intestine containing the tumour is then cut free and removed for testing, to see whether Hillary may need chemotherapy treatment.

She was yesterday recovering at Derriford Hospital and is due to return home within days.

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