RCS England calls for consistent approach to robotic-assisted surgery

Robotic-assisted surgery (RAS) can provide greater precision during operations, result in fewer blood transfusions, free up hospital beds, increase patient satisfaction and potentially lower rates of return to theatre.

Despite these advantages, RCS England said there are no formal processes for providing robotic training in the UK or Europe or introducing RAS to hospitals. Unregulated adoption has the potential to lead to varied accessibility, variable outcomes and possible patient harm, they added.

Now, the organisation’s guidance - Robotic assisted surgery - A pathway to the future – addresses the challenges and the promises of RAS, with recommendations on its safe adoption and expansion in the UK.

The guidance proposes a structured pathway for established surgeons who want to transition to robotic-assisted surgery, and identifies the relevant roles and responsibilities of key stakeholders for ensuring and maintaining safe autonomous practice in robotic surgery.

Despite the centralised approaches in Wales and Scotland, the current lack of a national strategy in England and Northern Ireland has meant that the use of robotics is often based on local availability, resources and expertise, rather than patient suitability and care. Also, there are currently no nationally recognised standards for established surgeons and surgical teams, and access to training, assessment, feedback and support is limited.

In a statement, Miss Nuha Yassin, consultant colorectal surgeon, robotics and minimally invasive surgery & RCS England 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. 

“To benefit from the potential advantages, any investment in purchasing robots needs to be accompanied by proper planning for its introduction into the 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.

Miss Yassin continued: “In addition to being a tool in the surgeon’s toolkit, robotics and computer assisted technology have the potential to provide a pathway to the future not just by improving the technical or mechanical aspects of surgery, but also by providing enhanced vision around preoperative or intra-operative imaging which aids with operative planning and accuracy. Incoming technologies in surgery can support intra-operative decision making. For example, through rapid pattern recognition and by converting data to information in a way that can support the operating surgeon’s judgement and perception - and steer them away from danger or error.”