A new wave of technology is set to transform surgery for millions of patients

An independent commission has predicted that surgery is about to be transformed for millions of patients by a new wave of technologies.

According to the report of the Commission on the Future of Surgery, co-authored by Imperial College London, patients can confidently expect surgery to become much less invasive and more personalised, with more predictable outcomes, faster recovery times and a lower risk of harm.

The report highlights four areas of technological development that are likely to have the greatest impact on how surgical care is delivered in the next two decades:

• Robot-assisted surgery and minimally-invasive surgery – meaning faster recovery times (including cardiovascular and gynaecological procedures)
• Imaging (including virtual, mixed and augmented reality) and patient-tailored implants from 3D printing
• Big data, genomics and artificial intelligence – meaning "precision" surgery, tailored to a patient's genes
• Specialised interventions like developments in transplants and stem-cell therapies - as well as 3D-bioprinting of tissues and organs and creating more advanced prostheses

Report co-author Professor Guang-Zhong Yang, the Director of the Hamlyn Centre for Robotic Surgery and the professor of Imperial's Department of Computing, pointed out that the role of medical robotics must be firmly established in clinical practices. “It is now important to drive the technologies, not only in terms of innovation, but also from the perspective of cost-effectiveness and general accessibility, such that the population at large can benefit from the technologies” he said.

Robotics and minimally-invasive surgery

Major developments in laparoscopic and endoscopic surgery will enable less invasive diagnostic and therapeutic procedures. The next generation of surgical robots – expected to be launched in 2019 – will be more slender, versatile and affordable and can be moved between theatres or even hospitals. These attributes will improve the take-up of robot-assisted surgery, with the potential to reduce variation in outcomes, as well as make robot-assisted surgery more widely available in local hospitals and will narrow the gap in performance between surgeons.

Big data, genomics and artificial intelligence

Advances in big data, genomics and artificial intelligence will enable ‘precision surgery’ – where treatments can be tailored to patients according to their genetic profile. Genomics has the potential to revolutionise surgical care by making some types of surgery redundant and by allowing doctors to better understand cancerous tumours and target treatment accordingly.

Imaging, virtual, mixed and augmented reality

The report suggests that virtual, mixed and augmented reality platforms will allow surgical teams around the world to share advice during operations, and specialist surgeons to carry out or support complex procedures remotely. The Commission also highlights the advantages of 3D imaging to support planning of personalised surgical interventions and creating patient-tailored implants using 3D printing techniques.

Specialised interventions

The expert panel has also considered specialised interventions such as some stem-cell therapies, 3D-bioprinting of tissues and organs, developments in transplant and neural prosthetics with adaptive control mechanisms. In the long-term, there will be more complex and specialised interventions. The delivery of cell-based therapies, bio-printed tissues and organs, ‘intelligent’ prosthetics or animal to human transplants will require specialised teams working together in multidisciplinary centres.

“It is an incredibly exciting time to be part of the surgical team, as technology is going to enable us to do so much more to keep our patients healthy. Better diagnosis and a more detailed understanding of how illnesses develop, thanks to advances in genomics and genetic testing, will give us the tools to tackle disease at an earlier stage. We will be able to act early and tailor surgery to the needs of individual patients, and therefore likely operating on patients who are otherwise well” Mr Richard Kerr, Chair of the Royal College of Surgeons Commission on the Future of Surgery, said.

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The press conference of the Commission on the Future of Surgery was held at the Hamlyn Centre for Robotic Surgery in Imperial College London on 6^th December 2018.

The report of the Commission on the Future of Surgery is available to download on the official website.