'Ten years ago this surgery was relatively novel...now it is very much in the mainstream'

As half of a cancer patient’s left lung is pulled through a golf ball-sized hole in her chest, the department's lead surgeon Tom Routledge said: “She'll be awake within half an hour, sitting up in a chair and having a cup of tea.”

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The procedure to remove tissue containing a small tumour took around an hour and a half.

For most of that time, Mr Routledge and his apprentice sat at twin consoles two metres away from the patient.

The senior medic, 53, helped to pioneer use of robotics in the NHS.

He said: “When I started doing this 10 years ago, it was relatively novel, kind of a niche thing, that a small number of enthusiasts did to develop the techniques.

“Now it has moved very much into the mainstream. The surgical community understands this is the way the majority of this type of surgery should be done.”

The robotic arms are inserted through four small incisions and have articulated “wrists” to allow precise, smooth movements.

One holds a camera while the others wield instruments. Mr Routledge works as a “proctor”, supervising surgeons learning to use the technology. Dr Christoph Zacherl, 35, has come from Austria to spend a year training in London.

Viewing the anatomy through a 3D display, the trainee, who has performed the same surgery by hand hundreds of times, uses a cauterising tool to cut through blood vessels with minimal bleeding.

The Da Vinci Xi system’s dual controls allow Mr Routledge to take over if needed to help tackle more “anomalous arteries”.

Learning to operate the robot is a bit like learning to drive a car, he explained. Trainees have already mastered the basics of manual surgery. They then practise using simulators and animal models before joining real procedures.