Inside the million-pound machine that will soon be performing keyhole surgery on Brits
IT is 10am, surgeon Jeffrey Ahmed has just finished his first operation of the day. His patient will go home to recover in her own bed within hours.
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Mr Ahmed says: 'This is the future. The benefits are so profound we can't not do it'
Credit: Jon Bond
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Surgeon Jeffrey Ahmed with The Sun's Sam Blanchard next to the surgical robot
Credit: Jon Bond
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The million-pound robot performs a hysterectomy in just 40 minutes
Credit: intuitive.com
Her hysterectomy, a major surgery, only took 40 minutes thanks to the million-pound robot used by Mr Ahmed and his team at the Chelsea and Westminster Hospital in London.
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Done by hand, the same procedure would have taken two hours or more, involved an overnight stay on the ward and could have cost an extra £2,000.
Health Secretary Wes Streeting has told Sun Health that robot- assisted surgery is the 'future of the health service' as our figures show its use is skyrocketing.
Robotic assistance was used in 70,000 procedures on the NHS in England last year.
That was double the 35,000 two years earlier in 2022, and a ten-fold increase on the 6,600 performed in 2014.
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The machines, which are operated by surgeons, are capable of increasingly complex and major operations.
They benefit doctors, patients and the health service.
An NHS report last week said the adoption of robots is now 'in the exponential phase', meaning it is rapidly increasing.
Officials say it will soon take over the majority of keyhole surgeries — such as gallbladder or appendix removal — and an increasing number of orthopaedic operations.
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Mr Ahmed conducts the hysterectomy — the removal of the womb — from a console in the corner of the operating room, where he sits with his shoes off and dance music playing in the background.
He uses hand controls as if he is playing on a Nintendo Wii to manoeuvre the Da Vinci Xi Robotic Surgical System.
Robot doctor that can perform surgery in space is destined for ISS
Tiny mechanical forceps and scissors slice the womb free from the bladder a millimetre at a time, cauterising the flesh as they go to prevent internal bleeding.
The robot's instruments are more compact than a surgeon's, so incisions are smaller, reducing infection risk, scarring and bleeding.
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'Blood loss is way less now,' Mr Ahmed tells Sun Health. 'It's about 25ml, so the patients lose more from the blood tests beforehand than the operation itself.'
A thin camera shows the inside of the body, and Mr Ahmed, the anaesthetist and nurses who are standing close to the patient to keep her safe watch the procedure on TV screens.
Mr Ahmed, 40, says: 'This is the future and I don't think there's any way of going back. The benefits have been so profound that we can't not do it.
'We're doing about 1.5 times the amount of cases we were able to do with traditional keyhole surgery, and the patient outcomes are better, so our patients are staying in hospital for a shorter time.'
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Not only does this mean people can recover at home and resume their daily life quicker — it also frees up vital beds in hospitals.
And patients need less anaesthetic because the operation is shorter — another risk reduction.
Mr Ahmen said: 'Previously, their average length of stay was 1.8 days, but our patient will go home today after a cup of tea and a sandwich in the recovery room. We've finished that case at 10 o'clock in the morning and, across the UK, there are a lot of surgeons who still don't have their first patient on the table.'
The first robot-assisted operation in the NHS was carried out in the year 2000. Now, there are more than 140 machines in use across the country.
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Health spending watchdog the National Institute For Health And Care Excellence last month gave the green light for hospitals to choose from 11 robotic systems.
This signals top-ranking officials believe they are worth the money.
Robo ops first took off in men's urology, operating on prostates and the pelvis, and are now increasingly used in gynaecology.
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The robot performs surgery as medics watch on screens
Credit: Jon Bond
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Surgeon Mr Ahmed manipulates the robot arms by remote control
Credit: Jon Bond
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The robot arms can be viewed on the screen
Credit: Jon Bond
It is particularly beneficial here because unwanted damage or mistakes can have devastating effects on patients' lives, leaving them with sexual dysfunction, fertility issues or incontinence.
Urological surgeon Ben Challacombe is the head of robotic surgery at Guy's and St Thomas' NHS trust in London.
He operated on TV legend Stephen Fry's prostate cancer using a robot and has also treated film director Steve McQueen.
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He says: 'In some hospitals, you'll get an experienced surgeon doing operations with a robot but in other hospitals, they won't even have the robot yet.
'We need to democratise it because it's a postcode lottery. The NHS should negotiate to buy them at a national level to level up.'
New departments are getting the help of robots all the time. They are now capable of heart surgery, mouth and throat operations, cancer treatment, hernia repair and even hip and knee replacements.
'Postcode lottery'
Mr Challacombe says: 'The next generation will be single port robots where everything can go through one incision and cause even fewer side effects.
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'In the future I think we will be able to train robots to do parts of the tasks automatically.
'They're a long way off being able to do an entire operation but we expect that sort of step up.'
Orthopaedic surgeon Al-Amin Kassam is trialling robotic hip replacements at the Royal Devon and Exeter Hospital.
He uses a machine to create 3D scans before a robotic arm implants the new hip socket.
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The physical bone work is done manually by surgeons. Mr Kassam said: 'The robot essentially works like a spirit level.
'During a manual implant, we put the replacement cup where our eyesight tells us to, but human eyes have a margin of error. It also means you have to open up the area more, cutting through more muscle and tendon so you can see.
'With the robot, you don't need the full view, so where most surgeons would cut three tendons at the back of the hip, we only need to cut one. It should improve patient recovery and get them back to activity and to work earlier.'
The NHS also needs patients' co-operation before robotic surgery becomes standard. Many may still have visions of rogue Terminator-style cyborgs at the operating table.
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But this could not be further from the truth, and the machines are not yet automatic. They can make only tiny movements controlled by qualified expert surgeons.
Some patients are scared to begin with because they think the surgeon is going to be in the coffee room while it's happening
Al-Amin Kassam
Mr Kassam says: 'Some patients are scared to begin with because they think the surgeon is going to be in the coffee room while it's happening.'
One patient who has been under the robotic knife is Ella Lacson, a 27-year-old from London. She has had the same endometriosis operation twice — once with a robot and once without.
Endometriosis is a painful condition and causes the abnormal growth of womb tissue in other parts of the pelvis area. In severe cases, surgery is needed.
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Client accountant Ella says: 'It felt like barbed wire in my pelvis and got so bad I couldn't go out with my friends or into the office.
Smash waiting lists
'I first had the surgery in 2012 which was really uncomfortable for a few weeks and I was off school for months. But after my second surgery with the robot in December 2024, the recovery was so quick.
'I went home the same day, managed the pain by myself for about two weeks and then I was back to normal. I've started doing dance classes again, which I couldn't do before.
'I didn't feel like there were any downsides. I'd 100 per cent recommend it to someone in the same position as me.'
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There are still some drawbacks, however, as machines typically cost upwards of £1million to buy and may initially disrupt efficiency.
Mr Challacombe says: 'I'm very pro-robot but the downsides are the cost, and people get less efficient before they get more efficient.
'If the consultants are learning, the trainee surgeons can't learn from them. There is also some danger to operating a machine that is away from you, extending the time it takes to spot potential problems.'
I'm very pro-robot but the downsides are the cost, and people get less efficient before they get more efficient
Ben Challacombe
He says reaction times with a camera view may not be as instant as up-close manual surgery.
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But most procedures go smoothly and, once theatres are fully up and running, the benefits are clear.
The ops are less physically taxing for surgeons, which could let them extend their careers, as many suffer back or shoulder problems.
Their speed and ease of use mean the machines can be used for high-intensity sessions when surgeons ramp up procedures at the weekend to help slash waiting lists. England has millions of patients waiting for 7.4million procedures.
Mr Ahmed's team in Fulham last year took part in a 'super surgery weekend', when two departments at the hospital operated on 59 patients in two days.
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Professor Naeem Soomro, from the Royal College of Surgeons, said: 'Robot-assisted surgery is here to stay.
'Used well and for the right patients, it has the potential to bring benefits including greater precision, fewer blood transfusions, increased patient satisfaction and a faster return to work and family.
'To get the most out of these tools, it is essential to make sure that staff receive consistent, high-quality training to use them.'
David Marante, vice president of Intuitive UK & Ireland, makers of Da Vinci robots, said: 'Innovative initiatives are bringing down waiting lists and improving productivity, helping save bed days, optimise staffing and improve efficiency.'
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