A robotic surgery revolution is set to save the NHS millions by slashing recovery times for urgent operations, as well as planned ones. Top surgeons are pioneering the UK's first programme dedicated to robotic-assisted emergency surgery 24/7. The technology sees medics control instrument-wielding arms inserted into the patient through keyhole incisions, allowing more precise movements and reducing damage to healthy tissue.

The Express spent a morning at Portsmouth's Queen Alexandra Hospital (QAH), where the scheme has already saved the NHS tens of thousands of pounds by getting patients home sooner. Mr Stuart Mercer, clinical director and upper gastrointestinal surgeon at QAH, said adoption of the technology had been slow but was "accelerating and definitely here to stay". He added: "This is a game-changer for emergency surgery in the UK.

"By applying cutting-edge robotic-assisted technology to the most urgent cases, we are not only improving outcomes for patients but also improving efficiency and setting new standards in care.

"We're at the point where it shouldn't really be seen as a luxury, it should be what people are expecting when they come in to have an operation in the NHS.

"Keyhole surgery and robotic surgery are without a doubt the best way to do this sort of thing." Keyhole surgery is far less invasive than open surgery, avoiding large incisions and leaving patients with less scarring and a lower risk of complications.

Using a robotic platform, such as the da Vinci Xi system at QAH, further increases precision. For example, patients with a burst or blocked bowel often need a stoma bag and several operations to recover. With robotics, surgeons can complete the repair in a single procedure.

Patients with gallstones and jaundice previously faced more than a week in hospital and two operations. Surgeons using robotics can remove both the gall bladder and gallstones at once, meaning patients are home in a few days and back to normal life within a week.

The NHS announced in June that a major expansion of robotic-assisted surgery will see the number of procedures soar from 70,000 to half a million per year over the next decade.

Hospitals have largely using the technology for elective, or planned, operations. But Mr Mercer said there were also huge benefits for urgent cases.

Patients coming into hospital for a scheduled procedure have time to prepare and can be advised to lose weight, quit smoking or make other lifestyle changes. Those needing emergency surgery are "clinically much sicker", Mr Mercer said.

He explained: "There's this real feeling that if you have two hits - first of all your injury or illness, and then surgery to deal with it - that is much more troublesome than just having the single hit of planned elective surgery."

Mr Mercer and his colleagues performed their first robotic emergency surgeries during the pandemic, when many planned operations were cancelled and the equipment sat idle.

Now, Portsmouth Hospitals University NHS Trust has agreed a deal with da Vinci manufacturer Intuitive to have the UK's first dedicated machine for emergencies. A new robot was delivered six months ago and around 40 patients have benefitted.

Each system typically costs around £2million but QA hospital has secured the technology on a pay-per-use basis.

The trust expects to increase the number of emergency procedures carried out with robotics from 20 to around 500 per year - saving an estimated 1,250 bed days annually.

Highlighting the example of emergency bile duct surgery, Mr Mercer said it costs around £1,100 more to use robotics than to perform the keyhole operation by hand.

However, between £10,000 and £20,000 is saved by avoiding extra tests or, in some cases, further surgery, and by getting patients home faster. The NHS spends around £1,000 a day for a patient in an ICU bed and £540 for a standard bed.

Mr Mercer and his colleagues recently analysed 35 emergency robotic surgeries. He said: "The extra cost of using the robot to do all those would have been somewhere between £40,000 and £45,000.

"The savings it probably generated were in excess of £200,000. It's definitely financially worthwhile, and for the patients it is without a doubt worthwhile."

Six criteria must be met to use robotics, including having trained staff available and being sure that it will not delay any planned care. During our visit, the Express observed a non-emergency robotic-assisted surgery to remove part of a 60-year-old man's oesophagus due to cancer.

The patient was expected to spend nine days in hospital - less than the usual 14 days for the same procedure with regular keyhole surgery.

Mr Mercer first came across surgical robots in 2016. He said: "I honestly couldn't see the point. It is more expensive on the face of it than doing standard keyhole or open surgery, and I couldn't see what it was going to add to my practice.

"Then I watched the next iteration of the da Vinci robot and it was clearly different. You had four arms, the vision was better, we could see how it was going to help.

"In the last three or four years, I have had absolutely no doubts that this is the correct direction of travel for keyhole surgery in the elective setting.

"And in the last six months to a year, I am totally convinced that for many emergencies it's going to be the future. I think we'll be using it for more emergency cases than we are at the moment."

Mr Mercer, who served as a medical officer in the Navy for 20 years, added: "The NHS isn't a great place to be at the moment, there are so many pressures in so many different ways.

"To do something a bit exciting, a bit different...it's given a lot of us a new lease of operating life."

Penny Emerit, chief executive at Portsmouth Hospitals University NHS Trust, said the programme was a "truly exciting development".

She added: "Having long been at the forefront of robotic-assisted surgery, we are proud to extend this innovation into emergency surgical care and further strengthen our position as a leader in this field.

"By using NHS resources more efficiently we can ensure that more people benefit from timely treatment and improved outcomes."

Professor Meghana Pandit, NHS England's National Medical Director, said: "Trailblazing technology such as robotic assisted surgery is a crucial part of building a health service that is fit for the future.

"It can help to reduce pressure across the system and cut waiting times by improving patients' recovery times, increasing surgical accuracy and reducing complications from invasive procedures.

"This cutting-edge technology was identified as one of the five "big bets" of the 10 Year Health Plan that will be essential in transforming the way the NHS works and it is developing quickly across the country - with around half a million operations expected to be robot-assisted each year within the next decade - a great example of how we're using innovation to improve patient care."

David Marante, vice president of Intuitive UK & Ireland, said: "Congratulations to the team at Queen Alexandra Hospital in Portsmouth.

"It's great to see this innovative A&E programme helping to reduce rates of open surgery, save bed days, improve patient outcomes and tackle health inequalities."

'The speed of recovery really suprised me.'

Robotic surgery was a "no-brainer" for Paul Adams when he needed both emergency and planned operations. The father-of-two knew nothing about the cutting-edge technology before he went to A&E in June with upper body pain.

Doctors diagnosed a gallbladder infection and a CT scan also revealed he also had a cancerous lump growing on his kidney. Paul, 60, underwent robotic-assisted emergency at Portsmouth's Queen Alexandra Hospital to remove his gallbladder.

He said: "I had a number of incisions, I think four across my belly, each about a centimetre wide. They took the gallbladder out through another incision by by belly button, which kept it nicely hidden. I was up and about after one day. Within two weeks, I was back to normal."

Paul spent around five days in hospital receiving intravenous antibiotics. He then returned in September for a second robotic-assisted operation to remove the large kidney tumour.

The internal sales engineer had the surgery on a Friday morning and returned home within around 24 hours.

He said: "I hate hospitals so it was brilliant to be able to go home and get on with life. It was so much nicer to be at home recuperating."

Paul is now back to health and enjoying his hobby of woodworking. He added: "I didn't know anything about robotic surgery when I first went in, I was expecting them to say it would be a big cut. The speed of recovery really surprised me.

"When it comes to the intrusion and the residual scarring, it's really a no-brainer. It just made perfect sense."

Robotic surgery is transforming care at Portsmouth Hospital University (PHU), delivering improved outcomes for patients while proving its worth financially.

As the largest single centre da Vinci robotic Centre in the UK, PHU has shown how precision robotics can shorten patient hospital stay, reduce complications and accelerate recovery; freeing beds and ultimately cutting downstream costs.

Crucially, the productivity gains are magnified when robotics are combined with high-intensity theatre (HIT) lists, meticulously planned, rapid turnover operating sessions championed by my team, which allow more procedures into standard sessions without compromising safety.

HIT lists reduce downtime and maximise use of expensive capital equipment, improving cost-per-case economics.

Economic evaluations underway at Portsmouth, including the MAYFLY multispecialty outpatient research study, are explicitly measuring clinical and cost outcomes, seeking to demonstrate that higher upfront capital and consumable costs are offset by shorter lengths of stay, fewer readmissions and faster return to work.

For taxpayers and patients this matters. Robotic surgery can reduce average bed days per patient and lower complication-related expenses, while HIT lists mean a single theatre and surgical team can safely deliver more operations in a day, spreading fixed costs across higher volumes.

That combination moves robotic surgery beyond expensive novelty to a scalable, value-for-money service within the NHS.

Portsmouth's experience shows investment, when paired with smart scheduling and robust outcome measurement, can both restore elective capacity and raise standards of care; a pragmatic blueprint for hospitals nationwide looking to marry fiscal responsibility with superior patient outcomes.

Patients experience smaller scars, less pain and quicker returns to normal life, while the health service benefits from improved throughput and long-term savings.

Wider adoption, backed by clear data, could deliver fairer access and sustainable NHS surgery nationwide.

- Mr Gijs van Boxel, Upper Gastrointestinal Surgeon