A London-based surgical team is advancing the use of robotic-assisted technology in lung cancer operations, part of a broader initiative to expand robotic keyhole surgery across England’s National Health Service (NHS). The effort is exemplified by consultant thoracic surgeon Sasha Stamenkovic, who recently demonstrated the da Vinci 5 robotic surgical system to visiting surgeons ahead of its scheduled introduction later this year at their hospital.

During a two-hour procedure at St Bartholomew’s Hospital, Stamenkovic employed the robotic platform to perform a delicate lung tumour removal, preserving healthy tissue by navigating around small blood vessels and airways. The surgeon operated while seated at a console, manipulating robotic arms that execute his precise hand movements within the patient’s body. A fourth robotic arm, equipped with a camera, provides a 3D view for enhanced visualization. Throughout the operation, his instructions to the surgical team, including specially trained nurses serving as robotic first assistants, were transmitted via microphone.

Stamenkovic, who directs robotic surgery and research at Barts Health NHS Trust and oversees fellowships aimed at training the “surgeon of the future,” emphasized the precision benefits of the technology. He noted that the robotic arms’ enhanced dexterity and fine motor control restore some aspects associated with open surgery, despite its minimally invasive approach. This improved accuracy can lower complication rates such as air leaks, which are a significant cause of extended hospital stays after lung surgery.

The government’s long-term plan envisions robotic assistance being employed in up to 90% of keyhole procedures in England by 2035. Advocates say the technology should enable shorter hospital stays and quicker recoveries, potentially easing pressures on NHS bed availability and surgical waiting lists. The experience of Ian Macleod, 76, who became the NHS’s first patient to undergo lung cancer surgery with the new system, supports these expectations. Macleod reported an “extraordinary” recovery, being mobile within half an hour of returning to his ward and leaving the hospital with a single stitch less than a week later.

Despite the promise of robotic surgery, challenges remain in its rollout. The Royal College of Nursing has criticized disparities across regions, describing a “postcode lottery” affecting patient access to robotic procedures. The organization also highlighted inconsistent funding models within the NHS, noting that some hospitals depend heavily on charitable donations to acquire this equipment.

Training is a critical component for expanding robotic surgery. Stamenkovic pointed out the need to integrate robotics more thoroughly into surgical education programs. He observed that younger surgeons in training often adapt more quickly to the technology and emphasized the importance of harnessing their enthusiasm and skills to foster wider adoption of robotic techniques across multiple surgical specialties, including thoracic, urology, gynecology, colorectal, and general surgery.