Robotics in surgery – weighing up the risks and benefits

Posted: 05/04/2022

As a follow up to her article published on the future of robotics in healthcare this time last year, this article from Victoria Johnson focusses on where robotics may be of most use and assistance in surgery, particularly in light of the Covid-19 pandemic.  

Recently, the media has picked up on the possibility of robotic surgery being helpful in tackling the backlog in operating theatres following the pandemic. This article from the Daily Mail in February 2022 reports that NHS waiting lists have reached an all time high and considers whether increased use of machines such as the Smart Tissue Autonomous Robot (STAR) would help alleviate this pressure.

However, as with all medical procedures, there are potential risks that need to be taken into account. In particular, the use of new tools requires thorough training. If the surgeon has not been trained correctly in the use of new technology, they may not be able to use the robot safely or know when its use is appropriate. There is also the possibility of design faults, manufacturing faults or software errors, which would not be so likely to apply in manual surgery.

The Daily Mail article refers to an American study, led by the Massachusetts Institute of Technology, which found that technical difficulties and complications did occur in robotic surgery, and that errors included ‘burnt or broken pieces of tools falling into the patient (14.7% of errors), electrical sparking that could injure patients (10.5%) and robots making unintended movements (8.6%)’. However, the article also points out that protocols have been tightened since the study was done, so the surgery has become safer.

Senior associate Tim Wright has considered in more detail the sad death of Stephen Pettit, who passed away following errors made during robotic-assisted surgery, in his article here. 

Some risks and complications are specific to robotics-assisted surgery, such as those listed above. However, it is important to remember that all surgeries carry risk, and the possibility of human error can be reduced by the appropriate use of robotics.

There are no current plans for surgeons to be completely replaced by machines, and supporters of robotic-assisted surgery outline that the use of robots may have a number of benefits both for the surgeon and for the patient. They point out that surgery will not take place unsupervised or unguided by a human surgeon, and the robots cannot make decisions or perform the surgery by themselves.

As such, they are more akin to an advanced surgical tool. They allow the surgeon to have more dexterity and precision, provide better access to the part of the body being operated on, especially if this is hard to reach, and give a better view of the operating area. For patients, this type of surgery often requires a much smaller incision, which reduces the chance of infection and blood loss and often leads to a quicker and better recovery as a result.

As with any innovation, there are likely to be safety concerns initially but, with thoughtful application and appropriate training, the use of robotics in healthcare seems likely to continue to increase.

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