Robots were first used in healthcare during the 1960s, but not in theatre. Instead, they were used to automate the manufacturing line and improve the assembly of healthcare products. In the years following this, they started to be introduced to a lab setting to support with experiments and testing.
Fast forward to the present day, and the use of robotics is far more widespread in healthcare - not just behind the scenes, but in clinical practice too.
More and more, robots are being used in a myriad of ways across healthcare; from carrying out elements of a procedure with full autonomy (“active”), to carrying out part of the procedure under direct control of the surgeon (“semi-active”), to aiding surgeons in theatre without being directly involved in the procedure (“passive”).
The extent to which robotics are used, and for which purposes, differs across each medical sector – but, on the whole, benefits to using this high-tech machinery include: the ability to operate with greater precision and visibility; reducing human error (natural tremor); the ability to locate often hard-to-detect primary cancer; easier access to the (small) cavities of the body and a view and dexterity that can preserve other structures (such as vital nerves and blood vessels}. In summary, they make our work feel much simpler, by providing improved visualisation and access, allowing a great sense of calm during surgery.
As a result, patients undergoing robotic assisted procedures have a shorter length of stay, lower risk of infection, less scarring, less blood loss and reduced pain. This results in shorter wait times for procedures – which proved particularly significant during the COVID-19 pandemic.
One sector that is rapidly advancing as a result of robotics use is gynaecology. Due to the pressure that the COVID-19 pandemic put on the national healthcare system, many women are facing longer waits for routine surgery for benign gynaecological conditions (such as troublesome fibroids, endometriosis, and uterovaginal prolapse ) which are seen to be less urgent despite often coming with debilitating pain and marked reduction in women’s quality of life.
However, using state-of-the-art robotic systems, like the da Vinci® Xi™ (offered by HCA Healthcare UK facilities), surgeons trained in robotic surgery are now able to perform major gynaecological surgery in an efficient, safe, and precise way – resulting in quicker surgery times for practitioners, and quicker recovery times for patients.
I had specialist training in robotic surgery at The Princess Grace Hospital (part of HCA Healthcare UK), having converted from traditional laparoscopy. I have now completed many complex robotic operations for endometriosis, including colorectal disease.
The training programme involved a series of specialist training exercises, including virtual simulation training, e-learning, face-to-face training, lab teaching, cases observations and, finally, supervised patient cases. Throughout the programme, I also received detailed assessments of my learning curve, peer reviews, and was proctored by Mr Tony Chalhoub – a leading UK consultant in benign robotic gynaecological surgery.
Following completion of my training, I - along with my colleague, expert colorectal robotic surgeon Mr Jim Khan – performed a robot assisted ‘discoid bowel resection’ for deep infiltrating endometriosis using the da Vinci® Xi™ System, on a 21-year-old female patient who had suffered a decade of painful and debilitating symptoms. We believe this was the first robotic operation of this kind performed in the UK and has resulted in full resolution of debilitating bowel endometriosis symptoms in this patient with full preservation of fertility function.
Robotic surgery is undoubtedly a solution to some of the challenges facing the field of gynaecology, so it is vital that healthcare providers have the necessary funds to introduce robotic systems to more surgeons in this sector. I’m excited to be part of this new robotic era, and to see how gynaecological surgery will evolve over time with their usage.
As a result of my training, HCA Healthcare UK has become the first hospital group in the UK to train a robotic surgeon in the independent sector. In addition to continuing gynaecology robotics training, there are plans for HCA Healthcare UK to expand its robotic training programme to include general surgery as well – including the treatment of colorectal conditions and hernias.