Robot-assisted surgery
robotics has really gained traction is converting a lot of open procedures into minimally invasive techniques.”
The death of laparoscopic surgery?
Jonathan went on to highlight a paper by Ferrari et al, in the US, titled: ‘The death of laparoscopy’.1
This retrospective analysis used
the American College of Surgeons’ National Surgical Quality Improvement Programme (ACS-NSQIP) databases from 2012 to 2021. The analysis included 360,171 patients across diverse procedures. In urology, robotic surgery dominated prostatectomies (83.1% in 2021) and nephrectomies (55.1% in 2021), while the open approach remained the predominant surgical technique for cystectomies (72.5% in 2021). In general surgery, robotic colectomies
were forecasted to surpass laparoscopy, becoming the primary approach by 2024 (45.7% in 2025). Proctectomies also showed a shift towards robotic surgery, predicted to surpass laparoscopy and open surgery by 2025 (32.3%). Pancreatectomies witnessed a steady growth
in robotic surgery, surpassing laparoscopy in 2021, with forecasts indicating further increase. While hepatectomies remained predominantly open (70.0% in 2025), oesophagectomies saw a rise in robotic surgery, predicted to become the primary approach by 2025 (52.3%). “For cystectomies (removal of the bladder) open surgery was still the predominant method in the US in 2021 and I suspect that’s where you’re going to start seeing a lot of the gains over the next decade,” Jonathan asserted. “I have a good friend who is an attending
surgeon in the Mayo Clinic, in the US, and he’s now having trainees who have gone through their entire training programme, never having performed laparoscopic surgery – they are now coming for a laparoscopic fellowship, so they can learn laparoscopic techniques, in case they have problems with the robot,” he commented.
Over 30,000 patients treated with Versius
Cambridge-based CMR Surgical also delivered a speed education session, during the symposium. The company highlighted Versius – the second most utilised soft tissue surgical robot in the world, which has now been used in over 30,000 surgical cases globally across a broad range of specialties including urology, general surgery, gynaecology and thoracic surgery. The small and modular design of Versius allows
the system to be set up in a way that gives the surgeon optimal access in small, hard to reach spaces within an operating zone. Delegates also learned that the set up takes 10-15 minutes, docking takes 5-8 minutes and undocking takes <10 minutes. Ultimately, faster turnover, fewer trays and
shorter stays mean that the robot can offer operational, as well as patient benefits. For surgeons, it offers stable visuals, ergonomic controls and precision, helping to reduce fatigue and risk.
Over 70% of hospitals that have introduced
Versius are using it across two or more specialties. In fact, it is now being used across 130 different procedure types. Teams that are
He pointed out that it has taken a while for
robotic surgery to take off in the UK. Barriers have included the cost, access to training and the evidence-base for use. However, there are trials underway, which should generate good evidence of the benefits of robotic over laparoscopic, he reported. Jonathan pointed out that the robotics market is about to become “an incredibly competitive landscape” and, with this competition, it is hoped that the cost will come down in the future.
Future trends Future trends in robotics include miniaturisation,
using the technology report higher morale, better collaboration and pride in pioneering modern surgery.
Clinical trials are currently taking place in paediatric surgery across Southampton Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, and Manchester University NHS Foundation Trust; and in transoral robotic surgery (TORS) at Liverpool University Hospitals NHS Foundation Trust’s Aintree University Hospital. CMR has also launched further enhancements
to Versius Plus including integrated fluorescence imaging system, vLimeLite, Versius Clinical Insights and the Ultrasonic Dissector – the first advanced energy instrument to be introduced to Versius – enabling surgeons to perform more complex surgical procedures with the system. The Ultrasonic Dissector promotes
haemostatic coagulation and simultaneous cutting, supporting surgeons during more complex surgical scenarios. With vLimeLite, surgeons can perform visual assessment of the vessels, blood flow and related tissue perfusion, as well as biliary anatomy during a range of surgical procedures.
with the development of micro and nano-scale robots for diagnostic and therapeutic applications, as well as advancements in digital technology and data integration. Furthermore, digital advancements like simulation, telementoring, and telesurgery have the potential to transform surgical education and training, as well as enable remote expert guidance and intervention. “With regards to dexterity, there will be
improved algorithms to help us with increased tremor as we get older. Some surgical robotics platforms are also talking about nine degrees of freedom. We have seven, at the moment, with current robots. “With regards to miniaturisation, there are some platforms which are looking at self- assembly of robots. This involves introducing the components of the robot, which then self- assemble in the body cavity; then they perform the operation and disassemble, so you can remove them again. Ultimately, the smaller the incision, the less pain, less opioid use, and less length of stay. There are robotics companies who are currently working on this. The ones who are most advanced tend to be endoscopic delivery,” Jonathan continued. He further explained how miniaturised
Over 70% of hospitals that have introduced Versius are using it across two or more specialties. 34
www.clinicalservicesjournal.com I July 2025
robots could be used to target atrial fibrillation. Electromagnets can be activated to generate non-harmful magnetic fields. The magnetic
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