The rise of robotic surgery in north east London

Robotic surgery is rapidly shaping the future of healthcare across the world, and in north east London it is already bringing life-changing improvements to patients with cancer and other serious conditions. Barts Health NHS Trust, one of the largest and most diverse NHS trusts in the country, has taken major steps to ensure its local population has access to the most advanced surgical technologies available today.

In 2024, with generous support from Barts Charity, the Trust was able to purchase three new surgical robots, increasing its total to five, making Barts Health one of the largest providers of robotic surgery in the UK. This expansion marks a significant leap forward for patients served by The Royal London Hospital, St Bartholomew’s Hospital, and Whipps Cross Hospital.

The population of north east London is culturally, linguistically, and religiously diverse. Over 100 languages are spoken across the boroughs the Trust serves. Many communities face long-standing health inequalities, and cultural beliefs often shape attitudes towards healthcare and new technologies. This makes the introduction of robotic surgery not only a clinical transformation but also a major opportunity to offer more equitable, inclusive care across the region.

Elly Brockbank, Consultant Gynaecological Oncologist at Barts Health, explains:

“Robotic surgery offers minimally invasive procedures that can reduce pain, shorten hospital stays, support faster recovery, and enable doctors to treat complex conditions that previously required open surgery.

“For cancer patients in particular, faster recovery and fewer complications can make a profound difference. Barts Health’s rapid expansion of robotic services means more patients can benefit sooner, and with more choice, than ever before.”

Patient Feedback on Use of Robotics

Understanding how patients feel about robotic surgery has been central to the Trust’s programme. To better appreciate patients’ perceptions, worries, and information needs, Barts Health carried out a major evaluation of patient-reported experience (PREM) between July 2024 and February 2025. The feedback was collected from 161 patients who had undergone robotic procedures.

Awareness and acceptance

The study found that awareness of robotic technology was generally good across the population, and acceptance of robotic surgery was high. Importantly, there was no evidence of significant concern or resistance from patients, an encouraging sign given the diversity of backgrounds, cultures, and health experiences across the local community.

However, the evaluation did reveal variations in levels of awareness between specialties, hospital sites, and ethnic groups. This suggests that information and conversations about robotic surgery will need to be tailored to match different patients’ backgrounds, understanding, and expectations. The Trust recognises that this is essential for delivering truly equitable care.

Information needs and communication

Patients overwhelmingly expressed a strong preference for traditional, face-to-face conversations with their surgeon as the primary way of receiving information about robotic surgery. This reflects the importance of trust and personal connection when making decisions about complex or unfamiliar treatment options.

Some patients, especially those who felt less confident raising questions, said they would benefit from information provided by specialist nurses, GPs, or online resources alongside their consultation. Early, accessible education in primary care could also help patients feel more prepared and able to take part in shared decision-making when meeting their surgeon.

The findings highlight the crucial role of the initial clinical consultation. Some patients reported anxieties about the technical and safety aspects of robotic surgery. Clear explanations of how robots are controlled, the surgeon’s role in operating the system, and the safety checks in place significantly reduce worry and build confidence.

High levels of satisfaction

Across all sites, patients expressed high levels of satisfaction with their robotic procedures, particularly due to quicker recovery, less pain, and shorter hospital stays. At Whipps Cross, for example, 90% of patients reported a positive experience, with some sharing glowing public reviews and others volunteering to speak about their experiences to help future patients.

The overall message from the PREM evaluation is clear: robotic surgery is well received and widely supported by patients, and the Trust is committed to refining the communication and education around it to make sure every patient feels confident and informed.

The Use of Robotics in Surgery in North East London

The expansion of robotic surgery across Barts Health is part of a wider strategy aligned with the North East London Acute Provider Collaborative and the Integrated Care Board, both of which prioritise reducing long-standing inequalities and improving access to advanced medical care.

Before these recent developments, north east London had fewer robotic surgery systems than other parts of London. With a population of more than two million people, the purchase of three new robots has dramatically improved the ratio to one per 280,000 people, bringing the region into line with the best-resourced areas of London.

Fiona Miller Smith, Chief Executive of Barts Charity, said: “What an achievement 600 additional surgeries are and great so many people will have new chances in life thanks to these robots. It’s fantastic to see technology improving efficiency in surgeries and cutting waiting lists. Thanks to Barts Charity funding, north east London’s population has access to world-class surgical services – and that is playing a huge part in reducing health inequalities”

Expanding across multiple specialties

The prior introduction and now expansion of robotic surgery has opened up opportunities across a wide range of specialties, including:

• Urology
• Gynaecology
• Gynaecology Oncology
• Colorectal surgery
• Upper Gastrointestinal (GI)
• Hepatobiliary (HPB)
• Ear, Nose and Throat (ENT)
• Thoracic surgery
• Cardiac surgery
• Paediatric surgery (planned)

Each site has broadened its range of robotic procedures. Whipps Cross, for example, now delivers robotic surgery in upper GI, colorectal, and gynaecology, including procedures for patients with very high BMIs or large fibroids who previously could only undergo open surgery.

The Trust has already seen well over 600 robotic procedures performed across its sites since the expansion and these numbers are rising steadily.

Supporting national NHS priorities

Robotic surgery directly supports the NHS Long Term Plan by:

• improving outcomes
• reducing complications
• cutting length of stay
• freeing up bed capacity
• boosting surgical productivity
• reducing inequalities in access to advanced treatments

With robotic systems now in place across north east London, thousands more patients will be able to benefit over the coming years.

An in-depth look at The Royal London Hospital

The Royal London Hospital has been at the centre of the robotic expansion programme. With the arrival of a new Da Vinci Xi robot in April 2024, funded by Barts Charity, thanks to the support of a generous gift in memory of Vahab Samadian, by his wife Dr Sima Motamen-Samadian in 2024. The hospital now runs two robotic theatres and hosts six specialties using robotic surgery: Gynaecology Oncology, Urology, ENT, Hepatobiliary, Colorectal, and Gynaecology, with a plan for peadiatric surgery to start in the near future.

Training for the staff to use this equipment was supported by a generous donation to Barts Charity from the Alamouti Family.

A rapid, large-scale training programme

To support this expansion, The Royal London Hospital delivered a major training programme for theatre staff, surgical trainees, and consultants. More than 40 clinical staff were trained in the early months alone, including:

• 37 theatre nurses
• 17 healthcare assistants
• 43 operational department practitioners
• multiple members of the theatre equipment team

The previously purchased robot was temporarily moved into the education centre to support intensive training, ensuring that both the surgical workforce and theatre support teams were confident and ready for the expansion of the robotic programme at The Royal London Hospital; using the technology safely and efficiently.

Increasing surgical capacity

By June 2024, The Royal London Hospital had begun running two simultaneous robotic theatre lists, and since then has seen a steady rise in the number of robotic procedures performed. The aim is to reach full utilisation of both robotic theatres five days a week by the mid 2026.

Innovation and new surgical services

The Royal London Hospital has used its expanded robotic capacity to introduce new procedures and specialist services, including, within for example, the urology team:

• benign functional and reconstructive urology
• robotic simple prostatectomy
• robotic colposuspension
• robotic reconstructive procedures for ureteric strictures and bladder diverticula

The colorectal team have launched a new robotic inflammatory bowel disease (IBD) surgery service. Robotic surgical teams are working together for advanced combined operations across specialties—for example, a hysterectomy with a complex abdominal wall hernia repair

The hospital has also appointed a new Surgical Care Practitioner, whose contribution has been described as “invaluable” in speeding up theatre turnover time and improving training opportunities for junior doctors.

Improving patient outcomes

Within just nine months of operating two robotic theatres, The Royal London Hospital carried out 321 robotic surgeries and recorded strong clinical results:

• Gynecology: operating times shorter than laparoscopic and open surgery; length of stay reduced from 3 days to 1
• Colorectal: expected 2-day reduction in length of stay
• Gynaecology Oncology: early-stage ovarian cancer staging now routinely possible via robotic surgery, enabling patients to go home the day after surgery

Teams at The Royal London Hospital have also played a leading role in research, publishing papers and collaborating internationally on pioneering procedures such as robotic abdominal wall reconstruction.

Benefits to Patients

Across all Barts Health hospitals, robotic surgery is delivering clear and measurable benefits to patients.

Shorter hospital stays

Length of stay has dropped significantly across many specialties:

• At St Bartholomew’s Hospital, cardiac bypass and mediastinal mass surgeries have seen reductions from four days to just one.
• Lung emphysema procedures now require around three fewer days in hospital.
• Gynaecology and colorectal patients at RLH and Whipps Cross have seen lengths of stay fall by one to two days.
• Same Day Discharge has already been introduced for some gynaecology oncology procedures and will be expanded to more specialties during 2025.

Faster recovery

Patients consistently report:

• less pain
• fewer complications
• quicker return to normal activities
• smaller scars and improved cosmetic outcomes

One St Bartholomew’s patient was reportedly playing golf just two weeks after robotic cardiac bypass surgery—a stark contrast to the lengthy recovery associated with traditional open procedures.

Improved access to minimally invasive surgery

Many patients who previously had no option but open surgery, due to high BMI, complex anatomy, or other risk factors, can now benefit from safer, less invasive procedures.

For example, women with large fibroids or high BMIs are now able to undergo minimally invasive hysterectomies at Whipps Cross, significantly improving their recovery and comfort.

High patient satisfaction

The vast majority of patients have expressed high satisfaction with their care. Their experiences confirm that robotic surgery is not only clinically effective but also greatly enhances the overall patient journey, from surgery through to recovery at home.

Benefits for Healthcare Professionals

Robotic surgery does not just transform patient care—it also improves the working lives of surgeons, nurses, and theatre staff.

Enhanced precision and ergonomics for surgeons

The robotic systems provide:

• 3D high-definition visualisation
• wrist-like instrument movement for enhanced dexterity
• improved ergonomics to reduce strain and fatigue
• greater ability to perform complex procedures safely

Some procedures are now significantly faster, freeing up theatre capacity and allowing more patients to be treated.

Better training opportunities

The expansion of robotic services has created new learning opportunities for:

• medical students
• junior doctors
• specialist trainees
• theatre nurses and HCAs

The Royal London Hospital alone has trained more than 40 surgical staff in a year, while St Bartholomew’s runs national and international fellowships in robotic thoracic surgery.

Improved teamwork and collaboration

Robotic programmes have brought together multidisciplinary teams across specialties and hospital sites. The ONWARDS steering group facilitates shared learning, while combined procedures—such as colorectal and gynaecology oncology joint operations—are becoming more common.

The introduction of Surgical Care Practitioners has also strengthened theatre teams, improving theatre efficiency and enhancing registrar training.

Conclusion

The introduction and expansion of robotic surgery at Barts Health NHS Trust has already made a profound difference to patient care in north east London. Backed by major investment from Barts Charity and its supporters, the Trust has rapidly grown its robotic surgery programme, enabling more patients, particularly those in historically underserved communities, to access world-class surgical technology.

From shorter hospital stays and faster recovery to improved training, increased collaboration, and pioneering innovations, robotic surgery is helping reshape healthcare across the region. The Royal London Hospital, St Bartholomew’s, and Whipps Cross are now firmly established as leaders in robotic surgery, with programmes that are inclusive, ambitious, and focused on delivering the best possible care for every patient.

As expertise continues to grow, and as the Trust works to improve communication, support, and patient understanding around robotic surgery, the benefits will only increase. The future of surgery in north east London is one of precision, innovation, and improved outcomes, ensuring that more patients can lead healthier, faster-recovering, and more confident lives after undergoing major procedures.