Robotic bedside assistance: When surgical evolution outruns regulation

Robotic surgery in England is undergoing rapid expansion, with projected growth from 70,000 procedures in 2023-24 to over 500,000 annually by 2035. This shift not only affects surgical technology but redefines perioperative roles – particularly bedside assistance. Despite growing attention from national initiatives such as Getting It Right First Time, regulatory clarity remains lacking. The scope and responsibilities of bedside assistants – a role often conflated with surgical assistance – vary significantly depending on professional background and qualifications. Without clear governance, perioperative practitioners may face liability risks, and patients are left exposed to inconsistent practice. This viewpoint highlights the urgent need for perioperative bodies such as The Association for Perioperative Practice and the Perioperative Care Collaborative to lead the development of national guidance specific to bedside assistance in robotic surgery. Doing so is essential to ensure safe practice, appropriate delegation, and professional accountability in this evolving surgical landscape.