A new era of robotic-assisted surgery is emerging within England’s National Health Service (NHS), as hospitals prepare to expand the use of advanced technology in keyhole operations. At the forefront of this development is consultant thoracic surgeon Dr. Sasha Stamenkovic, who recently demonstrated the da Vinci 5 robotic surgical system during a lung tumour removal procedure at St Bartholomew’s Hospital in central London.

Stamenkovic, director of robotic surgery and research at Barts Health NHS Trust, conducted the operation using a console that translated his hand movements into precise actions of three robotic arms equipped with surgical instruments. A fourth arm controls a camera that streams three-dimensional images, providing enhanced visibility for the surgeon and the operating team.

The robotic system’s design enables intricate manoeuvres, allowing surgeons to navigate around small vessels and airways more effectively than traditional keyhole techniques. Stamenkovic described this approach as a return to the dexterity and precision of open surgery, with the slim robotic arms facilitating movements that human hands cannot achieve easily within confined surgical spaces. He emphasized that the system enhances the "art form" of surgery by combining technical precision with delicate manual skill.

The NHS has set an ambitious goal for robotic assistance to be employed in 90% of keyhole operations across England by 2035. The technology is applicable across multiple disciplines, including urology, gynaecology, colorectal, thoracic, and general surgery. As part of this rollout, Stamenkovic oversees fellowships aimed at training surgeons to operate these complex systems. One trainee, senior cardiothoracic fellow Ali Ansaripour, acknowledged the challenge of "stepping away" physically from direct patient contact but highlighted the advantage of improved vision and objectivity during procedures.

Patient experience is also shaping perceptions of robotic surgery. Ian Macleod, a 76-year-old retired detective, became the first NHS patient to undergo lung cancer surgery using the da Vinci 5 system. He reported a notably swift recovery, contrasting it with prior non-robotic keyhole surgery for a different cancer. Macleod was discharged with just one stitch and was able to resume daily activities, such as driving, within a week.

While the government identifies robotics as a key investment in its 10-year health strategy aimed at improving surgical outcomes and reducing hospital stays, some concerns have been raised about inconsistent access. The Royal College of Nursing pointed to a "postcode lottery" in availability and criticized the lack of a uniform funding model across NHS trusts. Some hospitals have had to rely on charitable donations to acquire robotic technology, highlighting disparities that could affect patient care nationwide.

As robotic surgery becomes more prevalent, hopes are high that increased precision and reduced recovery times will alleviate pressure on hospital resources, shorten waiting lists, and improve overall patient outcomes. However, the NHS will need to address funding and access challenges to realize the government’s vision of widespread adoption by 2035.