Robotic-assisted surgery has changed what surgeons can see, reach, and accomplish through minimally invasive procedures. As these systems become more capable and more widely adopted, they are also changing the environment in which operating room teams care for patients.
In my 16 years as a perioperative nurse, I witnessed numerous advances in surgical technology, many which required new guidelines for patient safety, workflow, and recovery. As procedures become longer, more complex, and more dependent on technology, these guidelines must evolve at the pace of medical device innovation. The next generation of surgical innovation may not come from building a better robot, but from solving the problems that increasingly sophisticated procedures create around it.
New Patient-Safety Demands
Many robotic procedures require patients to remain in steep Trendelenburg or other complex positions for extended periods. Once the robot is docked, it becomes much harder for the team to make adjustments to patient positioning. That’s why getting positioning and securement right before the procedure begins is critical.
Accurate and safe positioning for robotic surgery is incredibly complex, and if the placement isn’t precise, complications like pressure injuries, peripheral nerve injuries, and patient slippage, can occur. Prolonged positioning can also create physiologic challenges that require close coordination between surgical and anesthesia teams.
These realities point to an often-overlooked area of opportunity for medtech companies. As robotic surgery advances, the supporting technologies around the patient need to advance with it.
That could mean developing better ways to secure and position patients, redistribute pressure during lengthy procedures, manage temperature, or provide clinicians with useful information without adding complexity to an already demanding environment.
The goal isn’t simply to add more technology to the OR. It is to address specific clinical problems that become more important as procedures become longer, more complex, and more technology-dependent.
Innovation should start with the clinical problem
For device developers, there is an important distinction between adding capabilities and solving problems.
A new surgical platform may offer greater precision or visualization, but its clinical value ultimately depends on everything happening around the patient as well. Positioning and securement technologies, for example, can help clinicians manage patient movement and pressure-related risks during lengthy procedures. Pressure redistribution surfaces can provide additional protection when patients remain in fixed positions for extended periods. [3, 5]
Temperature management is another important consideration. Maintaining normothermia is an established part of perioperative care, but lengthy, complex procedures can make consistent temperature management difficult.
The same principle applies to visualization. Fluorescence imaging and other enhanced visualization tools can provide surgeons with additional information about anatomy and tissue characteristics, supporting decisions during a procedure. [6]
These technologies address different clinical needs, but they share a common principle: they complement the surgical platform rather than compete with it.
For medical-device developers, that distinction is important. Innovation does not always mean building a new platform. Sometimes, it means identifying a problem that emerges as technology advances, and finding a better way to manage it.
The best technology fits with the way teams actually work
A device can work exactly as designed and still fall short if it does not fit the realities of the operating room.
Robotic procedures require close coordination among surgeons, nurses, anesthesia professionals, and surgical technologists. Each member of the team has a role in maintaining patient safety, communicating changes, and adapting as the procedure progresses.
Research has highlighted the important role of operating room nurses in positioning, injury prevention, communication, workflow coordination, and ongoing safety monitoring during robotic procedures. [1, 2, 4]
That means usability should be considered alongside technical performance from the earliest stages of device development. Does the technology fit naturally into the existing process? Can clinicians use it without adding unnecessary steps? Does it provide information or functionality when the team actually needs it? Can it work alongside equipment already in the OR?
These aren’t secondary considerations. In a highly coordinated environment like the OR, a device that creates additional complexity can introduce new challenges even when its underlying technology is effective.
The best innovations are often the ones that solve a real clinical problem without making the team’s job more difficult.
Recovery Begins With Intraoperative Decisions
The impact of surgical technology shouldn’t be measured only by what happens during the operation.
Positioning, temperature management, and injury prevention may seem like separate parts of perioperative care, but each can also influence what happens after surgery. Preventing avoidable complications can support a smoother postoperative course, while effective temperature management and pressure protection can contribute to patient stability, comfort, mobility, and recovery.
These outcomes also matter to healthcare organizations. Complications can contribute to longer recoveries, additional treatment, and greater demands on clinical resources. As hospitals look for ways to improve outcomes while managing capacity and efficiency, decisions made during surgery deserve greater attention.
For medical-device innovators, this creates a broader definition of innovation. The question should not simply be whether a device performs its intended function during a procedure. It should also be whether it helps clinicians provide safer, more consistent care and contributes to what happens after the patient leaves the operating room.
The next frontier is around the robot
Robotic surgery will continue to evolve and the rest of the operating room will have to evolve with it. That means addressing the patient-safety challenges that come with complex procedures, developing practical solutions for clinicians, and making sure new technologies fit into the way perioperative teams actually work.
After years of caring for patients in the OR, I have learned that successful innovation isn’t just about what a device can do. It is about whether that capability addresses a real clinical need, fits naturally into the team’s workflow, and ultimately makes care better for the patient.
The future of robotic surgery won’t be defined solely by how advanced the robot becomes. It will also be defined by how well the technologies around it help clinicians deliver safer, more consistent and more patient-centered care.
References
- Bjøro, et al. “Positioning Patients for Robotic-Assisted Surgery: A Qualitative Study of Operating Room Nurses’ Experiences.” Nursing Open, vol. 10, no. 2, 2023, pp. 469–478. Wiley. https://doi.org/10.1002/nop2.1312
- Lee, et al. “What Do Nurses Experience in Communication When Assisting in Robotic Surgery: An Integrative Literature Review.” Journal of Robotic Surgery, vol. 18, no. 1, 2024, article 50. Springer. https://doi.org/10.1007/s11701-024-01830-z
- Pires, et al. “Nursing Interventions to Promote Safety in Robotic Surgery: A Systematic Literature Review.” Journal of Perioperative Nursing, vol. 38, no. 1, 2025. https://doi.org/10.26550/2209-1092.1374
- Redondo-Sáenz, et al. “Perioperative Nursing Role in Robotic Surgery: An Integrative Review.” Journal of PeriAnesthesia Nursing, vol. 38, no. 4, 2023, pp. 636–641.
- Stefan, et al. “Ergonomics in Robotic Surgery: Patients’ Safety and Protection During Complex Procedures.” Mini-invasive Surgery, vol. 5, 2021, article 23. https://doi.org/10.20517/2574-1225.2021.24
- George, Evalyn I., et al. “Origins of Robotic Surgery: From Skepticism to Standard of Care.” JSLS: Journal of the Society of Laparoscopic and Robotic Surgeons, vol. 22, no. 4, 2018, e2018.00039. https://doi.org/10.4293/JSLS.2018.00039
Editor’s Note: Melissa Kelly is Global Clinical Manager at Gentherm Medical, where she focuses on the evolving role of technology in improving patient safety and surgical care. With experience working alongside clinical teams in operating rooms and intensive care units, she has seen firsthand the challenges clinicians face in managing patient temperature, positioning, and overall safety during procedures. Melissa has contributed to the development and advancement of solutions such as Gentherm Medical’s ThermAffyx™ Patient Safety System, which brings together warming and patient securement to address critical needs in the surgical environment. She is passionate about translating clinical insights into practical innovations that support better outcomes for patients and care teams.