NHS gets ‘game-changing’ robots to slash waiting times and save millions | UK | News
Surgeon Mr Stuart Mercer with his da Vinci surgical robot (Image: Adam Gerrard / Daily Express)
A robotic surgery revolution is planned to save millions on the NHS by reducing recovery times for emergency operations as well as planned operations. Top surgeons are leading the UK’s first program dedicated to 24/7 robot-assisted emergency surgery. The technology allows medics to control instrument-using arms placed on the patient through keyhole incisions, allowing for more precise movements and reducing damage to healthy tissue.
The Express spent a morning at the Queen Alexandra Hospital (QAH) in Portsmouth; here the program saved the NHS tens of thousands of pounds by getting patients home sooner. QAH clinical director and upper gastrointestinal surgeon Mr Stuart Mercer said adoption of the technology had been slow but was “accelerating and it’s definitely here to stay”. He added: “This is a game-changer for emergency surgery in the UK.
Surgeon Stuart Mercer explains his robotic surgery program
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“By applying the latest robot-assisted technology to the most urgent cases, we are not only improving outcomes for patients, but also increasing efficiency and setting new standards in care.
“We’re actually at the point where this shouldn’t be seen as a luxury, it should be something that people coming to the NHS for surgery should expect.
“Keyhole surgery and robotic surgery are undoubtedly the best ways to do this kind of thing.” Keyhole surgery is much less invasive than open surgery, avoiding large incisions and leaving patients with less scarring and a lower risk of complications.
Using a robotic platform, such as the da Vinci Xi system at QAH, further increases precision. For example, patients with a ruptured or blocked intestine often need a stoma bag and several surgeries to recover. Thanks to robotics, surgeons can complete the repair in a single procedure.
Patients with gallstones and jaundice had previously been hospitalized for more than a week and faced two surgeries. Surgeons using robotics can remove both the gallbladder and gallstones at the same time; This means patients can return home within a few days and return to their normal lives within a week.
The NHS announced in June that a major expansion of robotic-assisted surgery will see the number of procedures rise from 70,000 to half a million a year over the next decade.
Hospitals largely use technology for elective or planned operations. But Mr Mercer said there were also big benefits for emergency cases.
Surgeons control robot’s arms from a nearby console (Image: Adam Gerrard / Daily Express)
Patients who come to the hospital for a scheduled procedure have time to prepare and may be advised to lose weight, quit smoking, or make other lifestyle changes. Mr Mercer said those who needed emergency surgery were “much more clinically ill”.
He explained: “There’s a real feeling that if you get two hits (first your injury or illness, and then you have surgery to deal with it), it’s much more onerous than a single planned elective surgery.”
Mr. Mercer and his colleagues performed their first robotic emergency surgery during the pandemic, when many planned operations were canceled and equipment was idle.
University of Portsmouth Hospitals NHS Trust has signed a deal with da Vinci manufacturer Intuitive to have the UK’s first dedicated emergency machine. A new robot was delivered six months ago and approximately 40 patients have benefited from it.
Each system typically costs around £2 million but the QA hospital has secured the technology on a pay-per-use basis.
The trust expects to increase the number of emergency procedures performed with robotic technology from 20 to approximately 500 per year, saving an estimated 1,250 bed days per year.
Highlighting the example of emergency bile duct surgery, Mr Mercer said using robotics was around £1,100 more expensive than doing keyhole surgery by hand.
However, savings of between £10,000 and £20,000 are achieved by avoiding extra testing or, in some cases, further surgery and getting patients home faster. The NHS spends around £1,000 a day on a patient in an intensive care bed, compared to £540 for a standard bed.
Mr. Mercer and his colleagues recently analyzed 35 emergency robotic surgeries. He said: “The extra cost of using the robot to do all this would be somewhere between £40,000 and £45,000.
“The savings were probably over £200,000. It’s certainly valuable financially and certainly valuable for patients.”
Six criteria must be met for the use of robotics, including ensuring trained personnel are available and will not delay scheduled maintenance. During our visit, Express observed a 60-year-old man undergoing non-emergency robotic-assisted surgery to remove part of his esophagus for cancer.
The patient was expected to spend nine days in the hospital; this was less than the usual 14 days for the same procedure as regular keyhole surgery.
Mr Mercer was first introduced to surgical robots in 2016. He said: “To be honest, I couldn’t understand what this meant. Apparently it’s more expensive than doing standard keyhole or open surgery and I couldn’t see what it would add to my practice.
“Then I watched the next version of the da Vinci robot and it was clearly different. You had four arms, vision was better, we could see how that would help.”
“Over the last three or four years, I have had absolutely no doubt that this is the right way to go for keyhole surgery in the elective setting.
“And over the last six months to a year, I’ve been completely convinced that that’s going to be the future for a lot of emergencies. I think we’re going to use it for a lot more emergencies than we do now.”
Mr Mercer, who served as a medical officer in the Navy for 20 years, added: “The NHS is not a great place at the moment, there is a lot of pressure in so many different ways.
“Doing something a little bit exciting, a little bit different… has given a lot of us a new working life.”
Penny Emerit, chief executive of Portsmouth Hospitals University NHS Trust, said the program was a “really exciting development”.
He added: “Having long been at the forefront of robotic-assisted surgery, we are proud to extend this innovation into emergency surgical care and further strengthen our leading position in this field.
“By using NHS resources more efficiently we can ensure more people benefit from timely treatment and improved outcomes.”
Professor Meghana Pandit, National Medical Director for NHS England, said: “Breakthrough technologies such as robot-assisted surgery are a crucial part of creating healthcare fit for the future.
“It can help reduce stress on the system and shorten waiting times by improving patient recovery times, increasing surgical accuracy and reducing complications from invasive procedures.
“This cutting-edge technology has been identified as one of the five ‘big bets’ of the 10 Year Health Plan that will be needed to transform the way the NHS works, and is developing rapidly across the country – around half a million surgeries are expected to be robot-assisted each year over the next decade – it is a great example of how we are using innovation to improve patient care.”
David Marante, vice president of Intuitive UK & Ireland, said: “Congratulations to the team at Queen Alexandra Hospital in Portsmouth.
“It’s great to see this innovative A&E program helping to reduce open surgery rates, save bed days, improve patient outcomes and tackle health inequalities.”
Paul has had robotic surgery twice; One urgent, one elective (Image: Paul Adams)
‘I was really surprised by the speed of recovery.’
Robotic surgery was a “no-brainer” for Paul Adams when he needed both emergency and planned operations. The father-of-two knew nothing about the latest technology before going to A&E in June with pain in his upper body.
Doctors diagnosed a gallbladder infection, and a CT scan also revealed a cancerous lump growing on his kidney. Paul, 60, underwent robot-assisted emergency surgery at Portsmouth Queen Alexandra Hospital to have his gallbladder removed.
She said: “I had a few incisions on my abdomen, four I think, each about a centimeter wide. They removed my gallbladder through another incision at the belly button, which hid it nicely. I was back on my feet after a day. I was back to normal within two weeks.”
Paul spent about five days in the hospital receiving intravenous antibiotics. He then returned in September for a second robot-assisted surgery to remove a large kidney tumor.
The inside sales engineer had surgery Friday morning and was back home in about 24 hours.
She said: “I hate hospitals so it was fantastic to be able to come home and get on with life. It was even nicer to spend time at home recovering.”
Paul has now regained his health and is enjoying his hobby of woodworking. He continued: “When I first went, I had no knowledge about robotic surgery, I was expecting them to tell me there would be a big incision. The speed of recovery really surprised me.
“As far as the trespass and the scar left, it’s really very simple. It made total sense.”
Wider adoption could provide fairer access for patients, says GIJS VAN BOXEL
Robotic surgery is transforming care at Portsmouth Hospital University (PHU), proving its financial value while delivering better outcomes for patients.
PHU, the largest single-centre da Vinci robotics center in the UK, has demonstrated how precision robotics can shorten patients’ hospital stays, reduce complications and speed recovery; Freeing up beds and ultimately reducing downstream costs.
Most importantly, productivity gains are even greater when robotics is combined with high-intensity operating room (HIT) rosters, meticulously planned, quick-change operating sessions supported by my team that allow more procedures to be added to standard sessions without compromising safety.
HIT lists reduce downtime and improve cost economics per incident by maximizing the use of expensive capital equipment.
Ongoing economic evaluations at Portsmouth, including the MAYFLY multispecialty outpatient study, clearly measure clinical and cost outcomes and aim to demonstrate that higher upfront capital and consumable costs are offset by shorter lengths of stay, fewer readmissions and faster return to work.
This is important for taxpayers and patients. Robotic surgery can reduce average bed days per patient and reduce complication-related expenses; HIT lists mean that a single operating room and surgical team can safely perform more surgeries in a day and spread fixed costs across higher volumes.
This combination takes robotic surgery beyond expensive innovation to a scalable, value-for-money service within the NHS.
Portsmouth’s experience shows that investment, when paired with smart planning and robust outcome measurement, can both improve elective capacity and raise standards of care; A pragmatic plan for hospitals across the country that aims to combine fiscal responsibility with superior patient outcomes.
While patients experience smaller scars, less pain and a faster return to normal life, healthcare services also benefit from increased efficiency and long-term savings.
Wider adoption, backed by clear data, could deliver fairer access and sustainable NHS surgery across the country.
– Mr Gijs van Boxel, Upper Gastrointestinal Surgeon
