Robotic Surgery in the NHS: How Surgical Robots Are Changing Operating Theatres

Summary: NHS England is driving a major expansion of robotic-assisted surgery, aiming for 500,000 procedures annually by 2035, supported by new national guidance. Following NICE's conditional approval for 11 systems, the technology is expanding beyond urology into multiple specialities. Key benefits include shorter hospital stays, though the developing evidence shows longer operating times for some procedures.

Surgical robotics in the NHS has moved a long way from experimental technology to established clinical practice. From a relatively modest 6,600 robotic-assisted procedures performed across NHS hospitals in 2014, the figure had risen to 70,000 in 2023/24. NHS England now projects that…

Frequently asked questions

How does robotic surgery in the NHS actually work?

Robotic-assisted surgery, the term used by NHS England, is not autonomous. A surgeon operates from a console, controlling robotic arms that hold the instruments. The system provides a magnified 3D view, eliminates hand tremor, and enables movements with greater dexterity than the human wrist. This precision is especially valuable for complex operations in confined spaces, like the pelvis, improving access and control for the surgeon.

What are the main clinical benefits of robotic-assisted surgery?

Benefits vary by procedure. For radical prostatectomy, it is linked to shorter hospital stays (1–2 days), less blood loss, and fewer complications than open surgery. It can also mean a faster return to urinary continence than standard keyhole surgery. In colorectal surgery, it has been associated with a shorter hospital stay and a reduced post-operative stress response, although operating times can sometimes be longer.

Which robotic systems are approved for NHS use in the UK?

In April 2025, NICE gave 'conditional approval' for several systems, allowing use while more data is gathered. For soft tissue surgery, this includes Intuitive’s da Vinci, CMR’s Versius, and Medtronic’s Hugo. For orthopaedic procedures like knee replacements, approved systems include Stryker’s Mako and Zimmer Biomet’s ROSA. This guidance supports a coordinated expansion of robotics across NHS trusts.

How is the use of surgical robots regulated to ensure patient safety?

The use of surgical robots is regulated at multiple levels. Systems require NICE approval for use within the NHS, which is currently conditional upon further data collection. Furthermore, NHS England published national guidance in May 2025 that establishes a framework for how robotic programmes in hospitals should be governed. This includes specific recommendations for surgeon training, competency assessment, and the review of clinical outcomes to ensure high standards.