Robots and DNA coding to revolutionise surgery, commission says
New developments in robotics and DNA coding will revolutionise surgery by making it safer and less traumatic for millions of patients, an independent commission predicts.
The Commission on the Future of Surgery said advances in genomics could mean major cancer operations become redundant because patients can be offered other treatments earlier.
Its report, published on Friday, also said that new robots coming on the market in the next few years will make surgery safer. The commission’s chairman, Richard Kerr, said the sector was “on the cusp” of a digital revolution that could dramatically improve patient care.
He added: “The changes are expected to affect every type of operation – this will be a watershed moment in surgery.
“We will be able to act early and tailor surgery to the needs of individual patients, and therefore likely operating on patients who are otherwise well.”
The report said highly trained staff with the assistance of robots could perform routine parts of operations, with surgeons free to do very specialised procedures.
New robots expected in 2019 will be smaller and lighter which will make it easier for them to move between theatres and hospitals and make robot-assisted surgery more accessible.
The commission said robots will be more commonly used in gynaecological, colorectal and cardiothoracic surgeries.
It said trained surgical technicians could potentially perform endoscopy and endoscopic biopsies, removing skin lesions and even carrying out caesarean sections under the supervision of a surgeon.
Mr Kerr stressed surgeons will supervise the process and were likely to carry out the most critical parts of operations.
He added: “We are talking about specific procedures. This is always going to be under the watchful eye and careful supervision of a surgeon.
“These are highly qualified healthcare professionals and they will be trained in a specific aspect of that procedure.”
The commission said robotics will “digitalise” surgery, making complex procedures more precise through the use of smarter and smaller robots.
It also said that breakthroughs in genomics will make it easier to diagnose cancers and diseases and reduce the need for intrusive biopsies.
This would cut the need to perform major surgeries, such as removing organs affected by cancer, by allowing surgeons to pinpoint tumours through the use of targeted chemotherapy and radiotherapy as well as robots and nanotechnology.
It also said genomics could help patients with arthritis by allowing clinicians to identify those who have more aggressive forms of the condition and intervene sooner – potentially reducing the need for major surgery like hip replacements.
But commission member Professor Dion Morton stressed there will always be a need for surgeons capable of performing major operations.
He added: “These big, set-piece, operations will become less common as we are able to intervene earlier and use more moderate interventions.”
The commission said that surgeons will be able to use virtual and augmented reality to share advice and allow specialist surgeons to carry out or support an operation remotely.
The commission was set up in 2017 by the Royal College of Surgeons to investigate how technology will change the sector over the next two decades.
The authors also said scientific advances will make it easier to operate on older and frailer patients because surgery will be less traumatic.
The report said patients can “confidently” expect surgery to become less invasive and more personalised, with faster recovery times and a lower risk of harm.
The four areas where the greatest impact is likely to be felt are robot-assisted surgery and minimally-invasive surgery; imaging; big data, genomics and artificial intelligence; and specialised interventions such as stem-cell therapy and transplant developments.
However, the commission said that there were moral and ethical considerations to rolling out new treatments such as mapping people’s genome sequences and using animal organs for transplanting.
The commission has set out a number of recommendations including better planning the location of surgical robots and centralised services to make sure they are available to patients across the country.
It calls for NHS England to lead a robotics strategy to plan and purchase new systems.
Health Secretary Matt Hancock said he was determined to nurture a “culture of innovation” in the NHS.
He added: “I want to build the NHS into the most advanced health and care system in the world.
“Technology has the potential to revolutionise the NHS by equipping staff with life-saving tools, preventing diseases before they develop and empowering patients to take greater control of their own health.”
