Robotic surgery: speeding up your recovery

It may sound like science fiction, but robot-assisted surgery is very real. Consultant Surgeon Jim Khan talks to MedTech Views about some exciting developments that are already benefiting patients.

Robot-assisted surgery (or robotic surgery) allows doctors to carry out operations with more precision and control than is possible with traditional surgery. It involves a digital operating platform with a camera arm and mechanical arms that have surgical instruments attached to them, which are controlled by the surgeon remotely.

“The instruments are jointed so they can move in all possible directions like a human hand and have seven degrees of freedom,” explains Professor Khan, consultant colorectal and robotic surgeon at Portsmouth Hospitals University NHS Trust. “During surgery, the view is magnified ten times, and the surgeon has a very stable 3-D view of the surgical site.”

Compared with traditional laparoscopic (keyhole) surgery, which uses instruments that are a straight extension of the surgeon’s fingers, robotic surgery is revolutionary. “I’ve been doing robotics for 13 years and have done only robotic surgery for the past nine years,” he notes.

The benefits for patients are remarkable. “Because the instruments’ movements are more precise, there’s minimal damage to surrounding tissues, which means faster recovery, less pain, and shorter hospital stays for patients. Re-operation rates are lower and patient survival rates are significantly higher,” Professor Khan comments.

“Until recently, use of robotics was limited to longer, more complex procedures like prostate and cancer surgery, but since the technology has improved, we’ve ventured into other areas such as gastrointestinal, gynaecology and general surgeries. We were early adopters in Portsmouth. We got our first robot in 2012, and we now have four systems with over seven specialties using them.”

The use of robotics also has significant benefits for the medical team. “With robotics, the surgeon can control four arms, whereas in traditional surgery, a human only has two arms, so we need two assistants. Robot makes the surgeon less dependent on others.”

Professor Khan also points out the perceived soft benefits for surgeons: “A robot doesn’t get tired. Some operations can take four to five hours. Surgeons often get back and shoulder injuries, which means they have to stop or reduce the number of procedures they can do over time. Ergonomically, using robotics is much better for the longevity of the surgeon.”

Having seen the huge advantages that robotic surgery offers patients and doctors for longer surgeries, Professor Khan and his team wanted to explore whether these benefits could be extended to more straightforward same-day surgeries. “We’ve started using robotics in what we call low-complexity, high-volume cases, like gall bladder and hernia surgery,” says Professor Khan. “Not only have we seen fewer complications and re-admissions, but it also helps the medical team become more proficient and comfortable with robotics surgery. They’re doing five or six surgeries a day, versus the more complex operations where access to the robot is less frequent. This has huge training benefits. It’s a work in progress, but so far, we’re seeing a 92% success rate with these procedures. This is the way things will be in the coming decades.”