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RCS statement on need for national guidelines on the introduction of new procedures and technologies

09 Nov 2018

The Royal College of Surgeons (RCS) has responded to reports that the Newcastle Coroner intends to write to the RCS to ask whether there should be national guidelines on the introduction of new procedures or technologies, following the death of a 69-year-old man who suffered multiple organ failure after  robot-assisted heart valve surgery.

A spokesperson for the Royal College of Surgeons said: 

“We have noted reports that Newcastle Coroner, Karen Dilks, intends to write to the Royal College of Surgeons about this tragic case.
“Like the coroner, the RCS recognises the need for much clearer national guidelines on the introduction of new procedures and technologies. We are ready to work with the Department of Health and Social Care, and the General Medical Council, on developing such guidelines.
“It is wholly unacceptable for any surgeon to perform an operation they have not fully trained for.
“The use of robots is still relatively new in cardiothoracic surgery. There are specific pathways for training agreed between surgical robot manufacturers and NHS trusts for all operations in this specialty.
“Surgeons are also subject to the governance structures that are in place where they work. A majority of NHS trusts have guidelines for introducing and performing innovative surgical techniques, as well as using new technologies which trained surgeons are expected to follow as they expand their area of practice.
“Training to use a new technology, such as surgical robots, is a graduated process. To begin with, surgeons are expected to observe experienced colleagues carrying out procedures. Training on robotics in particular makes use of simulation, as well as animal or cadaver based training. Once they have completed an appropriate period of observation and simulation, they will move to proctorship where an expert guide will direct them during surgical procedures. The may also undertake a fellowship to further develop their skills. 
“They will be allowed to operate independently once they have demonstrated proficiency and safety in the procedural skills for the specific operation.”

Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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