Consultant surgeon Giuseppe Aresu worked with consultant anaesthetists at the hospital to perform the procedure on a patient who had a tumour called thymoma with associated myasthenia gravis, a condition which weakens body muscles.Surgeons normally treat thymoma by opening the chest with the patient under general anaesthesia, with a ventilator to aid breathing and under the effect of muscle relaxant and opiates to control pain. However, using the new technique (known as subxiphoid non-intubated thymectomy) - which had only been performed once before, in China - Mr Aresu was able to reach the tumour through a small cut between the abdominal muscles while the patient was allowed to breathe without assistance from a ventilator. Because the patient did not need ventilatory support or muscle relaxant drugs, the risk of respiratory complications after the operation was reduced. At the same time an anaesthetic team, led by Dr Andrew Roscoe, controlled the pain - targeting and blocking specific nerves with local anaesthetics and using a mixture of painkillers which did not include opioids and which allowed a faster recovery. Mr Aresu said: A thymectomy is a major procedure which usually involves a significant amount of recovery time. Using a minimally invasive surgical technique, in association with the spontaneous ventilation and opioid-free anaesthesia, we reduced the risks of post-operative complications. Royal Papworth Consultant Anaesthetist Dr Chinmay Patvardhan said that the new opiate-free anaesthetic method, combined with the minimally invasive surgical techniques, also had the potential to reduce a patients stay in hospital after surgery. Their recovery would be enhanced because physiotherapy and rehabilitation could begin within hours. The thoracic surgery team at Royal Papworth Hospital have since extended the technique to other types of operations; Mr Aresu performed the worlds first opiate-free lobectomy to remove a lung cancer.