Five ways technology will shape the future of surgery

A form of minimally invasive surgery, robot-assisted surgery can reduce variation in performance between hospitals, allow better access to traditionally hard to reach parts of the body and improves accuracy and precision in procedures.

It also, importantly, reduces risk for patients because it can magnify images and eliminate the fulcrum effect, which leads to fewer wound infections and shorter stays in hospitals following surgery.

Over the next two decades, the report predicts the development of new, improved surgical robots, as well as their use in more hospitals for a wider range of procedures. Concerns, however, about unpredictable mechanical issues and training will have to be addressed.

Building on NHS England’s 100,000 Genomics project, which has recently been extended into the NHS Genomic Service, genomic testing is expected to be central to the future of surgery over the next 20 years.

Although genomic testing brings huge benefits to patients and health systems since it can predict inherited disease risk, can act as a blood test for cancer, and contributes to improving targeted, precision medicine, the commission notes the need for healthcare providers to communicate with patients regarding how it should be used to prevent over-use of preventive surgery that may, in reality, be unnecessary.

Despite concerns about NHS readiness to implement it and lack of knowledge about long-term outcomes, 3D bio-printing of organs and tissues is expected to be key in surgery in the next two decades.

3D bio-printing involves layering living cells on top of each other to eventually create an artificial living tissue. Since it creates tissues and organs derived from the cells of the patient requiring a transplant, it eliminates the likelihood of rejection and the need for life-long immunosuppressive drugs.

3D bio-printed organs could also eventually cause a shift from requiring animal and human participants in drug trials, and similarly aid with developing personalised medicine.

AI algorithms analyse huge amounts of data quickly and can spot anomalies and provide useful insights. Surveys have revealed that the public is receptive to the use of AI to speed up and improve the accuracy of diagnosis and treatment.

Other future uses of AI include minimising surgical errors, facilitating the administrative side of surgery, such as scheduling procedures and requesting equipment, and to monitor patients both pre- and post-procedure.

However, the RCS remains concerned about the need to protect patient data and build up patient trust that their data will not be accessed without their consent.

Augmented reality (AR) and Virtual Reality (VR) are currently used by the NHS to help train the next generation of surgeons, as well as allowing them to rehearse procedures on patient-specific simulations; this will become more common across the country as hospitals invest in specialist suites.

AR and VR will also be used to connect inexperienced surgeons with specialist surgeons who can support complex procedures remotely. This is crucial for sharing knowledge standardising surgical outcomes across the country.

AR’s use in surgery expands beyond training; it can be used for surgeons to overlay data and visuals over a patient’s body to help improve successful outcomes.