How are robots easing pressure on healthcare?

For anyone who undergoes surgery, it’s natural to be nervous, but a seven-year-old boy named Reece was reassured when he was told that his kidney operation would be performed by a robot.

Reece’s mother Elizabeth told the BBC: “Reece was nervous about his operation before, but we showed him pictures and he was quite excited to know a robot was operating on him.”

The surgery, which was carried out last week at Southampton Children’s Hospital, saw Reece become the first child in the UK to undergo an operation using the Versius Surgical Robotic System.

Consultant paediatric urologist Ewan Brownlee used the robot to repair a narrowing of a vessel after Reece was diagnosed with an obstruction which inhibited the flow of urine from his kidney.

Dr Brownlee said: “This has been three years in the making so it’s really exciting for the whole paediatric urology team. I’m hoping that this is the start of seeing an increase in minimally invasive surgery for children all around the UK.”

Reece’s surgery was part of an NHS trial which sees Cambridge-based CMR Surgical’s Versius used in several hospitals to increase precision through the use of small surgical instruments, robot-assisted manual control and a magnified screen.

But it marks a wider adoption of robots across the healthcare sector, which is facing significant strain, thanks to ageing populations and a backlog of patients needing treatment following the Covid-19 pandemic. Could robots solve the challenges faced by the NHS and other healthcare providers?

Rise of the machines 

In the UK an ageing population is putting pressure on healthcare services. According to the country’s Office for National Statistics, the number of people aged 65 plus will grow from 12.7 million in 2022 (19% of the population), to 22.1 million in 2072 (27% of the population).

The fact that people are living longer could be, in part, down to improved healthcare services – new treatments and technologies mean ailments that were previously terminal can now be treated. But it also increases pressure on an already overwhelmed NHS.

This is compounded by the fact that the NHS has over 100,000 vacant roles, and waiting lists are at an all-time high.

As TechInformed recently reported, some NHS Trusts are turning to data analytics to tackle growing waiting lists. However, other hospitals have identified an even more noticeable technology – robots.

In surgery, robotic assistants offer “precise control” explains Jörg Zimmer, VP at software provider BlackBerry QNX. This “ensures accurate implant positioning and improved joint function.”

Plus, robots have the ability to make smaller incisions than surgeons, resulting in reduced trauma and faster recovery times for patients, Zimmer says.

Da Vinci coding

The Worcestershire Acute Hospitals NHS Trust introduced the ‘da Vinci Xi robot’ to the Alexandra Hospital in Redditch for this very reason.

The da Vinci Xi robot is positioned directly over a patient during surgery. It has four arms – three that can hold different surgical instruments and a fourth that holds 3D cameras. Each arm is operated by a computer that replicates the movements of an operating surgeon.

Brought in by business change consultancy Entec Si, the da Vinci Xi robot has been implemented to help with urological procedures and surgeries that can provide better outcomes for those affected with prostate cancer.

Entec Si ensured the introduction of the robot came with a “fit for purpose training plan,” explains Eman Al-Hillawi, CEO of the firm – including on-site training for surgeons, visits to other sites that already have the da Vinci Xi Robot, and procedural material to support learning.

“Having experienced surgeons on hand when the newly trained surgeons work through their first few procedures was also critical and extremely helpful,” says Al-Hillawi.

Alongside the technical installation of the robot, it required new technology infrastructure, including connectivity (such as upgrading the network), new applications and databases to be installed.

In addition, physical spaces, structural integrity of the rooms, load bearing and other construction challenges had to be addressed, the CEO explains.

Al-Hillawi says that the community around the hospital feel positive about the robot – during the lead-up to the implementation, local residents raised or donated a total of  £50,000 to ensure the project could go ahead.

“Before the introduction of the da Vinci Xi robot, many patients facing prostate cancer were forced to travel miles around the country to access treatment,” she adds.

This meant that, at the time, at least 80 to 100 patients each year were travelling away from their local area for the operation.

“With the increased capability brought about by the da Vinci Xi, patients now have faster, easier access to treatment in their local area.”

Since its implementation, Al-Hillawi says the hospital has recorded high levels of satisfaction with most patients being able to leave the day after surgery, a decrease from the four to five days needed before the robot was introduced.

“As this process is less invasive for the patient than laparoscopic procedures, the recovery times are also much quicker, with less blood loss and reduced complication rates,” she explains.

For surgeons, the robot means more training opportunities in this new field of surgery, as well as improved health benefits.

“These include the reduction in the likelihood that surgeons will develop musculoskeletal injuries, particularly in the back and hand which can lead to early retirement,” says Al-Hillawi.

Plus, “this means that the NHS Trust will be able to keep its skilled workforce for longer, and surgeons will be able to stay in their careers longer,” plus, the NHS Trust will be able to attract new talent.

Spray and go 

Robots are also being deployed to relieve overworked hospital staff by helping with tasks such as room disinfectant and medicine delivery.

During the COVID-19 pandemic, Swift Robotics received a £100k grant from Innovate UK, with support from Grantify, to build a UV disinfection robot.

“This initial success set the foundation for our growth and innovation,” says Michal Kostyal, co-founder of Swift Robotics.

“By introducing our robots, healthcare staff can focus more on direct patient care, which is especially critical during flu season when many staff members are ill.”

The robots are designed and manufactured in-house, in the UK.

Roaming the hospital floors, the bots are fully autonomous and modular in design – fitted with sensors combined with the proprietary software stack, the robots are able to “execute efficient dynamic path planning, obstacle avoidance, and localisation in a whole host of environments with varying complexities,” explains Kostyal.

The two bots not only help with cleaning, but are also used to deliver medicine, and medical tools across the floor.

Recently, the firm secured £1million in funding to enhance its AI and computer vision algorithms.  In collaboration with the Open University and Cranfield University, the funding will go towards boosting hospital resilience through the deployment of autonomous robots, explains Kostyal.

“Our robots are already in use in the UK and internationally, and this new funding will enable us to further improve and expand their capabilities.”

Get with the programming

BlackBerry QNX’s Zimmer said that to make further technological advances within the NHS a reality, “there needs to be a comprehensive strategy and investment in place to support manufacturers of these technologies and transform the industry to provide better patient outcomes.”

He explains that the success of robot-assisted surgeries relies on sophisticated software solutions that enable exacting precision and seamless communication between surgeons and robotic platforms.

Additionally, software developers building surgical robot applications need to ensure high-performance and hard real-time deterministic behaviour, so the robots can respond instantly to commands with low latency – a feature that is particularly critical in delicate procedures.

Robot assited surgeries also need to be fail-safe and fault-tolerant, so that a failed component or process won’t take down other components, the system can be restarted, or taken to a design-safe state.

“When it comes to reliability in surgical robotics, manufacturers need a trusted and proven solution,” says Zimmer.

The robot must show real-time deterministic behaviour, and adherence to rigorous safety standards, combined with a comprehensive set of security features, he says.

“Choosing the right technology will allow us to revolutionise the field of robot-assisted surgeries, setting new standards for the future of healthcare.”