New research into robotic surgery highlights the benefits of this technology for patients’ recovery time.
Is robotic surgery the future of healthcare? A new study has found that robotic surgery reduces the chance of readmission by 52% and reduces the prevalence of blood clots by 77%.
Co-Chief Investigator Professor James Catto, Professor of Urological Surgery at the University of Sheffield’s Department of Oncology and Metabolism, said: “This is an important finding. Time in hospital is reduced and recovery is faster when using this advanced surgery. Ultimately, this will reduce bed pressures on the NHS and allow patients to return home more quickly. We see fewer complications from the improved mobility and less time spent in bed.”
The study was published in JAMA and carried out by the University of Sheffield and University College London.
Trialling robotic surgery in nine UK hospitals
338 patients with non-metastatic bladder cancer from nine UK hospitals were randomised into two groups: 169 patients had robotic surgery to remove the bladder with intracorporeal reconstruction (the process of taking a section of bowel to make a new bladder), and 169 patients had open radical cystectomy.
The primary outcome was the length of hospital stay following surgery and the second measurement was readmittance rates. The researchers found:
- On average, the robotic surgery group stayed eight days in hospital versus normal surgery patients who remained in hospital for ten days.
- Hospital readmittance within 90 days after surgery was reduced: 21% for the robot-assisted group versus 32% for open radical cystectomy.
The researchers found that patients’ physical activity, monitored by daily steps tracked on a wearable smart sensor, improved with enhanced stamina and quality of life.
Researchers said the findings provide the strongest evidence so far of the patient benefit of robot-assisted surgery and are now urging the National Institute of Clinical Excellence (NICE) to make it available as a clinical option across the UK for all major abdominal surgeries, including colorectal, gastrointestinal, and gynaecological.
Robot-assisted surgery versus open surgery
Co-Chief Investigator, Professor John Kelly, Professor of Uro-Oncology at UCL’s Division of Surgery & Interventional Science and consultant surgeon at University College London Hospitals Trust, said: “Despite robot-assisted surgery becoming more widely available, there has been no significant clinical evaluation of its overall benefit to patients’ recovery.
“In this study, we wanted to establish if robot-assisted surgery, when compared to open surgery, reduced time spent in hospital, reduced readmissions, and led to better levels of fitness and quality of life; on all counts, this was shown.
“An unexpected finding was the striking reduction in blood clots in patients receiving robotic surgery; this indicates a safe surgery with patients benefiting from far less complications, early mobilisation and a quicker return to normal life.”
In open surgery, a surgeon works directly on a patient and involves large incisions in the skin and muscle; however, robotic surgery allows surgeons to guide minimally invasive instruments remotely using a console and aided by a 3D view. This technology is only available in a small number of UK hospitals.
NICE continues to recommend open surgery as the “gold standard” for highly complex surgeries, but the researchers hope that this could change.
Professor Kelly added: “In light of the positive findings, the perception of open surgery as the gold standard for major surgeries is now being challenged for the first time.
“We hope that all eligible patients needing major abdominal operations can now be offered the option of having robotic surgery.”