Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

Louisa Lawrie; Katie Gillies; Loretta Davies; Jared Torkington; John McGrath; Richard Kerr; Arul Immanuel; Marion Campbell; David Beard

doi:10.1136/bmjopen-2022-067427

Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

Louisa Lawrie, Katie Gillies, Loretta Davies, Jared Torkington, John McGrath, Richard Kerr, Arul Immanuel, Marion Campbell, David Beard

Research output: Contribution to journal › Article › peer-review

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Abstract

Objectives The effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to ‘current issues’ as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.Design Semi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participants The interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introduction and delivery of RAS services across the UK, including service managers and policymakers/commissioners. Two focus groups were also conducted with surgical trainees (n=7) and members of the public (n=8), respectively.Results The results revealed a largely positive attitude towards the introduction of RAS technology and an expectation of continued rapid expansion. Areas perceived to be particularly pertinent and requiring ongoing attention were also highlighted, including the need to achieve improved quality control, expertise quantification and training issues and the need to educate the public. Issues of centralisation, service organisation and equity of access were also emphasised.Conclusions Our study has highlighted a range of issues perceived to be particularly pertinent to the current and future provision of RAS which should be addressed. The areas outlined can enable healthcare managers and surgeons to plan for the adoption and/or expansion of RAS services.All data relevant to the study are included in the article or uploaded as supplementary information.

Original language	English
Article number	e067427
Number of pages	15
Journal	BMJ Open
Volume	12
Issue number	11
Early online date	1 Nov 2022
DOIs	https://doi.org/10.1136/bmjopen-2022-067427
Publication status	Published - 1 Nov 2022

Bibliographical note

Acknowledgments
We thank the participants for their time, energy and invaluable insight to assist this research. Thanks to Clare Robertson for facilitating the public focus group.

Funding This work was supported by Intuitive Surgical (European Research Board) via an unrestricted grant.

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Cite this

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title = "Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study",

abstract = "Objectives The effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to {\textquoteleft}current issues{\textquoteright} as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.Design Semi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participants The interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introduction and delivery of RAS services across the UK, including service managers and policymakers/commissioners. Two focus groups were also conducted with surgical trainees (n=7) and members of the public (n=8), respectively.Results The results revealed a largely positive attitude towards the introduction of RAS technology and an expectation of continued rapid expansion. Areas perceived to be particularly pertinent and requiring ongoing attention were also highlighted, including the need to achieve improved quality control, expertise quantification and training issues and the need to educate the public. Issues of centralisation, service organisation and equity of access were also emphasised.Conclusions Our study has highlighted a range of issues perceived to be particularly pertinent to the current and future provision of RAS which should be addressed. The areas outlined can enable healthcare managers and surgeons to plan for the adoption and/or expansion of RAS services.All data relevant to the study are included in the article or uploaded as supplementary information.",

author = "Louisa Lawrie and Katie Gillies and Loretta Davies and Jared Torkington and John McGrath and Richard Kerr and Arul Immanuel and Marion Campbell and David Beard",

note = "Acknowledgments We thank the participants for their time, energy and invaluable insight to assist this research. Thanks to Clare Robertson for facilitating the public focus group. Funding This work was supported by Intuitive Surgical (European Research Board) via an unrestricted grant.",

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AU - McGrath, John

AU - Kerr, Richard

AU - Immanuel, Arul

AU - Campbell, Marion

AU - Beard, David

N1 - Acknowledgments We thank the participants for their time, energy and invaluable insight to assist this research. Thanks to Clare Robertson for facilitating the public focus group. Funding This work was supported by Intuitive Surgical (European Research Board) via an unrestricted grant.

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N2 - Objectives The effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to ‘current issues’ as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.Design Semi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participants The interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introduction and delivery of RAS services across the UK, including service managers and policymakers/commissioners. Two focus groups were also conducted with surgical trainees (n=7) and members of the public (n=8), respectively.Results The results revealed a largely positive attitude towards the introduction of RAS technology and an expectation of continued rapid expansion. Areas perceived to be particularly pertinent and requiring ongoing attention were also highlighted, including the need to achieve improved quality control, expertise quantification and training issues and the need to educate the public. Issues of centralisation, service organisation and equity of access were also emphasised.Conclusions Our study has highlighted a range of issues perceived to be particularly pertinent to the current and future provision of RAS which should be addressed. The areas outlined can enable healthcare managers and surgeons to plan for the adoption and/or expansion of RAS services.All data relevant to the study are included in the article or uploaded as supplementary information.

AB - Objectives The effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to ‘current issues’ as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.Design Semi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participants The interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introduction and delivery of RAS services across the UK, including service managers and policymakers/commissioners. Two focus groups were also conducted with surgical trainees (n=7) and members of the public (n=8), respectively.Results The results revealed a largely positive attitude towards the introduction of RAS technology and an expectation of continued rapid expansion. Areas perceived to be particularly pertinent and requiring ongoing attention were also highlighted, including the need to achieve improved quality control, expertise quantification and training issues and the need to educate the public. Issues of centralisation, service organisation and equity of access were also emphasised.Conclusions Our study has highlighted a range of issues perceived to be particularly pertinent to the current and future provision of RAS which should be addressed. The areas outlined can enable healthcare managers and surgeons to plan for the adoption and/or expansion of RAS services.All data relevant to the study are included in the article or uploaded as supplementary information.

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JO - BMJ Open

JF - BMJ Open

IS - 11

M1 - e067427

ER -

Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

Abstract

Bibliographical note

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