Using robots in operations could boost efficiency and free up beds, say surgeons

Using robots to assist in operations could make surgery more efficient and free up NHS beds, a report has suggested.

The Royal College of Surgeons of England (RCS England) has published a guide: Robotic Assisted Surgery – a pathway to the future; exploring the potential benefits and challenges of the technology.

It said the document “provides a structured pathway” for surgeons who want to transition to robotic-assisted surgery, which allows doctors to operate with more precision using interactive, mechanical arms.

The report outlined “significant advantages” of using robots in surgery, including reduced post-op pain, fewer blood transfusions, more efficient use of anaesthetics and shorter hospital stays for patients.

According to RCS England, robotic-assisted surgery was first introduced in the UK in the late 1990s.

It has been adopted for cardiac operations and in urology and, while it remains “experimental” in other specialities, it is currently available in more than 100 hospitals in the UK.

However, the college said that despite recent growth in robotic-assisted surgery “there are no formal processes for providing robotic training in the UK or Europe, or introducing RAS to hospitals”.

It added: “Unregulated adoption has the potential to lead to varied accessibility, variable outcomes and possible patient harm.”

Nuha Yassin, consultant colorectal surgeon, robotics and minimally invasive surgery; and RCS England’s council lead for the future of surgery, robotics and digital surgery, said: “This timely new guidance will support the safe and structured introduction of robotic assisted surgery – and the fruitful collaboration between hospitals, surgeons and industry.

“It’s important for the surgical profession, led by RCS England, in collaboration with the surgical speciality associations, to take charge of all processes, accredit training centres and pathways and facilitate equity in access and training.”

Miss Yassin also called for the “proper planning” of investment in robotics for its introduction into the health service “with a focus on training, quality assurance and efficiency”.

“This also needs to acknowledge the variable learning curve which can be long for some surgeons and theatre teams before these efficiencies can be observed at a large scale,” she added.

Professor Neil Mortensen, outgoing president of the RCS England, said: “The 21st century has brought an increasing variety of less invasive ways to treat disease and to carry out surgery.

“It is possible that robotic surgery will eventually reach an era where a robot could perform pre-programmed tasks, complementing human performance.

“This is likely a long way in the future and it comes with significant additional ethical and systemic considerations.

“It is also important to establish the right relationship with industry, being clear and transparent around what constitutes conflict of interest and creating an effective dialogue that will benefit both patients and surgical education.”

Robots could also be helpful in training surgeons, Prof Mortensen said.

“At a time when there is less exposure of trainee surgeons to theatre time, robotic-assisted surgery simulation could be an opportunity to safely expose them to the spectrum of case complexity and expand the capacity of the surgical workforce.”