The IDEAL framework for surgical robotics: development, comparative evaluation and long-term monitoring.

Journal: Nature medicine
Published Date: Jan 19, 2024

Abstract

The next generation of surgical robotics is poised to disrupt healthcare systems worldwide, requiring new frameworks for evaluation. However, evaluation during a surgical robot's development is challenging due to their complex evolving nature, potential for wider system disruption and integration with complementary technologies like artificial intelligence. Comparative clinical studies require attention to intervention context, learning curves and standardized outcomes. Long-term monitoring needs to transition toward collaborative, transparent and inclusive consortiums for real-world data collection. Here, the Idea, Development, Exploration, Assessment and Long-term monitoring (IDEAL) Robotics Colloquium proposes recommendations for evaluation during development, comparative study and clinical monitoring of surgical robots-providing practical recommendations for developers, clinicians, patients and healthcare systems. Multiple perspectives are considered, including economics, surgical training, human factors, ethics, patient perspectives and sustainability. Further work is needed on standardized metrics, health economic assessment models and global applicability of recommendations.

Authors

  • Hani J Marcus
    The Hamlyn Centre for Robotic Surgery, Institute of Global Health Innovation, Imperial College London, Paterson Building (Level 3), Praed Street, London, W2 1NY, UK, hani.marcus10@imperial.ac.uk.
  • Pedro T Ramirez
    Department of GynOnc and Reproductive Medicine, The University of Texas Health Sciences Center at Houston, Houston, TX, United States.
  • Danyal Z Khan
    Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, University College, London, United Kingdom; Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College, London, United Kingdom.
  • Hugo Layard Horsfall
    Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, University College, London, United Kingdom; Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College, London, United Kingdom. Electronic address: Hugo.layardhorsfall@ucl.ac.uk.
  • John G Hanrahan
    Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom.
  • Simon C Williams
    Department of Neurosurgery, St George's Hospital, London, United Kingdom.
  • David J Beard
    RCS Surgical Interventional Trials Unit (SITU) & Robotic and Digital Surgery Initiative (RADAR), Nuffield Dept Orthopaedics, Rheumatology and Musculo-skeletal Sciences, University of Oxford, Oxford, UK.
  • Rani Bhat
    Department of Gynaecological Oncology, Apollo Hospital, Bengaluru, India.
  • Ken Catchpole
    Department of Anaesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.
  • Andrew Cook
    NIHR Coordinating Centre and Clinical Trials Unit, University of Southampton, Southampton, UK.
  • Katrina Hutchison
    Department of Philosophy, Macquarie University, Sydney, Australia.
  • Janet Martin
    Department of Anesthesia & Perioperative Medicine, University of Western Ontario, Ontario, Canada.
  • Tom Melvin
    School of Medicine, Trinity College Dublin, Dublin, Ireland.
  • Danail Stoyanov
    University College London, London, UK.
  • Maroeska Rovers
    Department of Medical Imaging, Radboudumc, Nijmegen, the Netherlands.
  • Nicholas Raison
    Department of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
  • Prokar Dasgupta
  • David Noonan
    Moon Surgical, Paris, France.
  • Deborah Stocken
    RCSEng Surgical Trials Centre, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
  • Georgia Sturt
    Bowel Research UK, London, UK.
  • Anne Vanhoestenberghe
    School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Baptiste Vasey
    Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
  • Peter McCulloch
    Nuffield Department of Surgical Science Level 6, John Radcliffe Hospital, Oxford OX3 9DU, UK. Electronic address: peter.mcculloch@nds.ox.ac.uk.

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