, 2025-04-17 15:16:00
Eleven robotic systems for soft tissue and orthopaedic surgery have been approved for NHS use by the National Institute for Health and Care Excellence (NICE).
The approval comes with the caveat that the systems should only be used while evidence of their effectiveness is being collected and reviewed.
Five of the approved systems are for soft tissue procedures, including hernia repair, tumour removal, and gallbladder surgery. The remaining six are for orthopaedic surgery such as full and partial knee replacements and hip replacements.
Benefits and Future Potential
The use of robotic technology, which is capable of movements more precise than the human hand, could lead to shorter hospital stays, faster recovery, and a quicker return to work. Patients may also experience less pain and reduced scarring compared with traditional surgery.
“Robot-assisted surgery is crucial to the future of high-quality healthcare,” said Professor Sir Stephen Powis, NHS national medical director. He added that that less invasive procedures and shorter recovery times could have a “knock-on effect throughout the system and help patients get treated quicker.”
List of Approved Technologies
The five soft tissue systems recommended by NICE are:
- Da Vinci SP
- Da Vinci X and Xi
- Hugo Robotic-Assisted Surgery System
- Senhance Surgical System
- Versius Surgical System
The six systems for orthopaedic use are:
- Apollo Knee System
- CORI Surgical System
- Mako SmartRobotics
- ROSA Knee Solution
- SkyWalker Robotic-Assisted Technology
- VELYS Robotic-Assisted Solution
Each system costs between £500,000 and £1.5 million and is typically used only in specialist centres.
Evidence Required Before Wider NHS Rollout
The recommendation comes under NICE’s Early Value Assessment process. The technologies can only be used if robust evidence is being gathered. This evidence includes the learning curve for the surgeon and the centre, as well as the effect on patient outcomes, such as rates of conversion to open surgery, length of hospital stay, complications, and health-related quality of life.
NICE plans to review the evidence after 3 years to decide if the technologies should be adopted across the NHS.
“Robot-assisted surgery may help overcome key limitations of conventional techniques through precise movements and enhanced 3D visualisation, potentially transforming surgical options and outcomes for NHS patients,” said Dr Anastasia Chalkidou, NICE’s HealthTech programme director. “Applications could benefit patients who might not otherwise be candidates for minimally invasive approaches,” she added.
Growing Use of Robotic Surgery in the UK
Robotic surgery has expanded significantly since the first platform was used in 1985.
In 2011-2012, only 20% of robotic procedures in England were for conditions other than urological cancer. By 2023-2024, that had risen to 49%.
Colorectal surgery now accounts for 25% of all robotic procedures, according to NICE. Orthopaedic robot-assisted surgery has grown rapidly, from about 300 procedures in 2018-2019 to more than 4000 in 2023-2024.
The technologies are expected to help reduce hospital stays for some procedures and surgical waiting times. They may also reduce the need for additional treatment after surgery and expand access to minimally invasive procedures for certain groups.
Supporting the NHS Workforce
NICE noted that robotic systems could make training in minimally invasive surgery easier.
Because surgeons operate the systems from a console, physically demanding procedures may become less taxing. This could allow more surgeons to carry out complex procedures and potentially extend their working lives.
John McGrath, consultant urological surgeon at North Bristol NHS Trust and chair of the NHS England Steering Committee for Robotic Assisted Surgery, welcomed the approval. He called it “a further milestone in surgical innovation,” but emphasised the need to build expertise in robotic surgery across the NHS to maximise patient benefit.
Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written three books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.