Robotic Assistance Systems in surgery

The use of robotically assisted surgical systems (RAS) in surgery shows great promise, especially when the capabilities of humans and robots are combined. Designed to improve quality of treatment, RAS are an important advancement of digitalization in the operating theatre.

Depending on the indication, RAS are used to varying degrees in Swiss operating theaters today. The majority of radical prostatectomies, for example, are already performed with the help of RAS, and their use in endoprosthetics is growing rapidly. RAS procedures on the brain, spine or ear, nose and throat medicine (ENT), as well as in visceral surgery, are now standard and expanding quickly around the globe.

Although RAS have been applied in Switzerland for over 20 years, evidence-based data remains inconsistent. For example, the advantages of minimally invasive RAS surgery are immediately evident in indications such as ENT or in the field of urology where surgeons face very limited access and visibility. In contrast, evaluating RAS in the context of endoprosthetics can take decades before conclusive data on frequency of revisions becomes available. The large number of indications and continuous launch of new RAS systems by diverse manufacturers makes comparison even more difficult.

Issues such as data protection, data security, and matters of liability are key and relevant legal requirements must be met. Furthermore, cost-intensive financing and inadequate reimbursement restrict access to robot-assisted treatment options for hospitals and consequently for patients.

Valid reasons to better utilise the potential of RAS

Broader application of high-precision and lower-stress treatment options
Many indications already benefit from robot-assisted surgery as it facilitates precise, standardized procedures and reduces impact on patients. The use of surgical robots enables greater accuracy, more efficient working methods, and exact placement for example of implants. Treatment outcomes become less dependent on the surgeon’s experience or form on the day. This produces better results, shorter recovery times, and overall enhanced quality of care in many areas. The corresponding Swiss surgical classification (CHOP) additional code for robot-assisted inpatient operations also supports measurements of positive effects (registries) and ensures correct allocation of costs for potential future adjustments to reimbursement for RAS-guided operations in hospital.

Robotics as a chance to overcome diverse challenges 
Demographic shifts and the shortage of skilled staff are creating major issues for our healthcare system. It is becoming increasingly difficult to guarantee high-quality care due to the rising number of elderly patients and lack of available staff in hospitals. The use of RAS can help counteract workforce shortages. For example, RAS reduces the physical strain on surgeons and thus enables a broader integration of specialists. Furthermore, education can be accelerated through optimized training programs and simulators.

Investment in medical products of the future
The future development of RAS will be shaped by artificial intelligence and augmented reality. By utilizing large amounts of data and real-time imaging during surgery, RAS helps doctors take data-based decisions, avoid errors, and achieve better treatment outcomes. A glimpse into the future indicates that robotics has the potential to further advance medical care. Registries such as the Swiss Implant Registry (SIRIS) are already providing initial insights into the use of robotics when implanting endoprostheses. 

Strengthening Switzerland as a medtech and innovation location 
The integration of robotics into medical care in the Swiss healthcare system offers significant benefits for patients, professionals, and the healthcare system as a whole. Close collaboration between the various stakeholders, research institutions, and professional associations is required to harness the full potential of robotics and ensure the best possible patient care.

Conclusion

• Robot-assisted surgeries represent high quality patient care.
• Medical progress and the widespread use of quality-enhancing technology in Switzerland should be promoted.
• Improving framework conditions for robot-assisted technologies is essential to ensure broader implementation.
• Establishment of appropriate reimbursement for robot-assisted interventions is required.