Comment: Robotic innovation is helping NHS Scotland deliver better healthcare

Surgical robots have been championed by NHS Scotland for a few years, and the opportunity to supplement expert surgeons in very precise procedures is now bearing fruit, producing less invasive procedures and quicker recovery times.

NHS Fife has been a leader in that regard, announcing earlier this year that it had reached a significant milestone of more than 500 patients being treated using pioneering robotic-assisted surgery. Introduction of the technology has further enabled Fife patients with prostate cancer to receive surgery without having to travel further afield.

In fact, the Victoria Hospital in Kirkcaldy was the first District General Hospital in Scotland to adopt robotic-assisted surgery (RAS) in 2021, with support from the Scottish Government of around £2.2m, and was proud to achieve the 500 patients milestone through colorectal, gynaecological and urological surgeries.

Da Vinci

The DaVinci robotic system introduced in Fife two years ago has been used by laparoscopic surgeons who have been able to operate the console device from within the theatre, with consultant surgeons across a range of specialities now further trained in the system’s use.

Since its implementation, RAS has allowed procedures to be carried out with greater precision and ease, and with reduced post-operative pain – in turn, helping to shorten the average length of hospital stay – and leading to reduced likelihood of readmission through complications.

Mr Satheesh Yalamarthi, NHS Fife Consultant surgeon and Clinical Director, who oversees the RAS programme in Fife, hailed the “the proven benefits it offers for patients”.

Another major milestone was reached by NHS Golden Jubilee in April last year when it became the first Scottish health board to carry out more than 100 orthopaedic joint replacements with the pioneering Robotic Surgical Assistant (ROSA) robot.

Put in a wider context, that meant the Golden Jubilee also achieved the second highest number of ROSA procedures carried out in the UK.

NHS Golden Jubilee Consultant orthopaedic surgeon, Nick Holloway, said: “This technology drives precision, accuracy, reduces variation and helps improve the predictability of outcomes for patients.”

He added that surgeons can now “pre-plan and essentially see the outcome on screen before the patient is even under anaesthetic”.

NHS Grampian

Last year, NHS Grampian – supported by the Urological Cancer (UCAN) Charity and the NHS Grampian Charity – became the first centre of excellence for RAS with the aim of establishing a fellowship training programme. NHS Grampian now has its fourth surgical fellow, following its first in 2016.

The health board’s urology department achieved that status for teaching fellows in stone and prostate cancer robotic surgery and is now hosting trainees on behalf of the European Urology Scholarship Programme (EUSP).

Thomas Lam, NHS Grampian Consultant urological and robotic surgeon and clinical lead for the department, said it would allow the region to attract the “best-of-the-best”.

He added that it had highlighted NHS Grampian’s credentials “as an internationally recognised centre of excellence for training in robotic urological surgery”.

Elsewhere in Scotland, robot-assisted technology is set to have a major impact in more domestic settings and across a range of medical specialties. In Lanarkshire, a forward-thinking health and care facility is forging a new path in the early development of what is being termed “the next generation of robotics”.

Blantyre LIFE, a ground-breaking care development opened last year, has already forged an international reputation for its progressive robot-led approach.

Indeed, trips from overseas have been undertaken by interested parties to find out more about pioneering use cases such as tech enabled homes, helping to place Scotland on the map while improving lives and fostering independent living through robotic assistance.

South Lanarkshire University Health and Social Care Partnership has helped to spearhead the development of a ‘social robot’ with human-like characteristics which could have the power to make safe decisions informed by machine learning, thus reducing pressures on healthcare staff.

National Robotarium

Research, supported by the National Robotarium’s world-leading know-how at Heriot-Watt University in Edinburgh, has helped to further gather insights from health and social care staff on their attitudes towards an early robot prototype which aims to assist people recovering from injury.

Professor Soumen Sengupta, Chief Officer of South Lanarkshire University HSCP said the work “represents our commitment to both amplifying – not replacing – expertise with latest technology and working with academic partners in a highly innovative space.”

Head of Human-Robot Interaction (HRI) at the National Robotarium, Professor Lynne Baillie said the robot would offer verbal guidance and encouragement to patients during exercise, while using its limbs to demonstrate the proper exercise stance.

“We believe that this engagement can help empower patients to stick with their exercise regime and improve their overall wellbeing,” Professor Baillie added.

Originally spun out of the health service through formal NHS Scotland partner InnoScot Health, Glasgow-based CardioPrecision – a specialist in less invasive treatment of structural heart disease – played a leading role this year in bringing the world’s first robotic aortic valve replacement through a tiny incision in the neck significantly closer to reality.

It demonstrated a proof-of-concept AVATAR (Advanced Videoscopic Aortic valve surgery by Transcervical Approach using Robot-assistance) procedure in Chicago. This was successfully performed on a series of human cadavers, representing a landmark moment in progressing towards clinical cases.

There is much to be proud of across Scotland then and vast potential to tap into.

With specialised training, more opportunities for surgeons to carry out robotic-assisted procedures, and domestic potential being meaningfully explored, this expanding avenue of innovation could be set to help build a stronger, more agile NHS Scotland.

Workforce innovators can be supported in their robotic ambitions through the help and guidance of InnoScot Health which encourages them to submit their ideas.

Graham Watson is Executive Chair of InnoScot Health