Robot-assisted surgery
Teamwork vital for successful robotic surgery
In this article, Minija Joseph and colleagues at the King’s College NHS Foundation Trust discuss the critical role of theatre nurses and anaesthetic practitioners in robot-assisted surgery.
Robotic surgery has revolutionised the field of minimally invasive surgery by improving precision and patient outcomes. While much of the focus is on the surgeon’s mastery of the robotic system, the role of the theatre team is equally critical to the success of these procedures. The team not only prepare and manage the robotic system but also play a vital role in maintaining patient safety, coordinating surgical activities, and troubleshooting equipment during real-time operations. This article highlights the contribution of
Theatre Nurses and Anaesthetic Practitioners in robot-assisted procedures and emphasises their evolving responsibilities as key members of the surgical team. By analysing real-world cases and detailing the comprehensive training programme, we aim to acknowledge their expertise and importance in achieving efficient and successful surgical outcomes.
Growth in robot-assisted surgery Robotic surgery has seen exponential growth due to its ability to offer surgeons enhanced precision and control, leading to better patient outcomes. Between May 2023 and March 2025, our surgical team performed a diverse range of robotic procedures; in total more than 600, including 145 radical nephrectomies, 115 colorectal resections, 91 gynaecological procedures and over 200 bariatric and upper GI procedures with a single robot. While attention is directed toward the surgeon’s proficiency with robotic systems, the Theatre Nurses and Anaesthetic Practitioners play an equally vital role in ensuring the success of these procedures. In robotic surgery, Theatre Nurses and Anaesthetic Practitioners are responsible not only for the care and preparation of the patient but also for ensuring that the intricate robotic systems function correctly. Their work behind the scenes ensures that surgeries proceed smoothly, and their ability to adapt and respond quickly to challenges enhances both the safety
and efficiency of robotic procedures. A rigorous and structured training
programme has been developed to ensure that Theatre Nurses and Anaesthetic Practitioners are equipped with the necessary skills to manage these complex systems. This article seeks to shed light on the often-overlooked contributions of Theatre Nurses and Anaesthetic Practitioners, recognising their critical role in the success of robot-assisted surgery.
Preoperative duties The success of robotic surgery begins long before the surgeon takes control of the robotic console. Theatre Nurses and Anaesthetic Practitioners are responsible for ensuring that both patient and robotic system are fully prepared for the procedure. This involves: l Patient Preparation: Theatre staff play a critical role in positioning the patient for robotic surgery. Given the precision required by robotic systems, even small misalignments in positioning can affect the surgeon’s ability to operate effectively.
l Robotic System Setup: Theatre Nurses are responsible for preparing the robotic system, including verifying that the robotic arms, instruments, and camera are functioning correctly. This involves performing checks to ensure that all robotic components are sterile and functioning optimally.
l Instrument and Supply Preparation: Robotic surgery implemented with six instrument and scope sets. Ensuring the availability of appropriate instruments is another key responsibility. Whether it is the use of staplers (green, blue, white) or advanced instruments, nurses ensure that the right tools are available at the right time during procedures.
Incorporation of specialised training Our programme at KCH selected seven core Theatre Nurses (super users) for the robotic surgery initiative. These staff members underwent comprehensive training, including: l Regular Meetings and Communication: Weekly updates shared during Robotic Board
July 2025 I
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