English hospitals aim to ramp up use of robotics in surgery

The UK government has announced plans to invest more in robotic equipment for English hospitals and set a target for robotic assistance to be used in 90% of keyhole surgeries carried out in England by 2035.

The government highlighted robotics as one of five "big bets" in a 10-year health plan for England, alongside other transformative technologies: data, AI, genomics and wearables. 

At St Bartholomew's Hospital in central London, visiting surgeons are among the first to be trained to use the new da Vinci 5 robotic-assisted surgical system, made by US company Initiative. The system, which includes three robotic arms that can hold surgical equipment, is controlled using an immersive 3D headset and a video-game-like console.

Robotic surgical systems like this can be used across a range of specialties including urology, gynecology, abdominal, colorectal, and thoracic or general surgery. 

The precision of robotic-assisted surgery should mean shorter hospital stays and quicker recovery times, which will take strain off a struggling health service with year-long waitlists, workforce shortages and discharge bottlenecks.

"The ability to have lots of integrated computer-aided technology on top" of human-controlled robotics "makes this precise surgery. It makes it safe surgery," says Sasha Stamenkovic, Director of Robotic Surgery and Research at Barts Health NHS Trust.

As well as improving recovery times, the greater precision also reduces the risk of complications like air leaks, a common cause of longer hospital stays following lung surgery. 

Ian Macleod was the first patient in Britain's NHS to undergo lung cancer surgery using the new da Vinci robotic system. Macleod says he "didn't realize" until he was wearing a surgical gown and anesthetised that he would hold this groundbreaking title, but the news "didn't faze" the 76-year-old retired detective.

Thirty minutes after the robotic-assisted operation, Macleod was back on his feet. "It was extraordinary," he says. "In fact, after the operation, I found out quite quickly that I only had one stitch." He had undergone non-robotic keyhole surgery for a different cancer in the past, and says the recovery time was "much longer". This time, he was driving his wife to the garden centrer for coffee less than a week later.

Stamenkovic runs fellowships at St Bartholomew's training surgeons on this new technology. He says it is the young surgeons who pick up the new robotic control system the fastest and who become the most adept. 

"They've come with different skill sets," he says, "they've probably come with gaming skill sets, some of them have come with a musical background." 

Laying out his long-term mission, Stamenkovic added: "All we need to do is harness their energy, their passion, their skill set, and teach them the right moves. And that will make the surgeon of the future."