Problem addressed, background and strategic significance
Robots were first approved to help surgeons perform operations in 2000. The surgical robot has been used to make some operations, particularly those in confined spaces, easier for surgeons to carry out consistently well. The first robots were not universally adopted due to relatively high cost and often longer operating times compared to standard ‘keyhole’ surgery. In addition, high quality research comparing conventional ‘keyhole’ surgery to robotic colorectal surgery showed no difference in patient outcomes. These studies tested robotics in the hands of the best keyhole surgeons who were perhaps able to operate to a consistently high standard without robotic assistance.
Robotic technology is now developing rapidly and new surgical robots are being released. We think that the practical ‘teething’ problems of early robotic systems will be overcome and that robotic assisted surgery will move towards the mainstream. We now need to consider if adoption of robotic technology can reduce variability in how operations are performed in order that we carry out more good operations that meet patients’ expectations. Robotic technology has the potential to transform training, it might be used to set standards that tell us when an operation is done well and it may even allow surgeons to work more comfortably, reducing stress and fatigue so that operations can be performed more quickly with fewer mistakes.
Introduction of technology may also have drawbacks or unforeseen consequences. It is incredibly important that we consult public and patients so that they may be in control of their own health care. We need to better understand the priorities and concerns of patients when considering how best to integrate robotic technology into everyday surgical care. This study will inform surgeons of patient and public views regarding development of robotic surgery.
Surgeons will tell us what questions they think must be answered before we adopt robotic assisted surgery. We will use social media to invite interested public and patients to attend five workshops across three continents. Experienced patient advocates will support this process and expert surgeons will be in attendance to help with technical questions. We will ask participants discuss how research studies should be designed to answer questions relevant to patients’ needs. We will ask participants at these workshops to rank the questions provided by clinical teams in order of importance. We will also encourage people to state if they have different priorities.
Hoped for results of this research
We will document patient and public views of robotic assisted surgery and use this information to inform development of an international strategy that is relevant to the populations that we treat.
What further plans are proposed for future development?
We are working with major stakeholders and government agencies to develop a UK plan for evaluation of robotic technology in surgery. These agencies would welcome wider overseas participation.