Robotic surgery has become an increasingly important part of modern Upper Gastrointestinal (Upper GI) practice, particularly for complex benign conditions involving the oesophagus and stomach. When applied within a structured training framework and supported by appropriate clinical governance, robotic techniques can offer greater precision, improved visualisation, and a refined minimally invasive approach.Â
I am Ash Rohatgi, a Consultant Upper GI Surgeon working across Whipps Cross Hospital and University College Hospital (UCH) in London. My robotic Upper GI practice has been developed through a formal, supervised pathway, with a focus on patient safety, technical precision, and appropriate case selection.
This page outlines my approach to robotic Upper GI surgery, the rationale behind it, and how it fits into contemporary surgical care.
Robotic Upper GI surgery is a form of minimally invasive surgery performed using a robotic surgical platform. The surgeon controls the instruments from a console, translating natural hand movements into highly precise actions inside the body.
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Compared with conventional laparoscopic surgery, robotic systems offer:
High-definition 3D visualisation
Greater range of motion than standard laparoscopic instruments
Improved stability in confined or complex anatomical areas
In Upper GI surgery—where procedures are often performed close to vital structures in the chest and upper abdomen—these features allow for more controlled and deliberate surgical dissection.
Upper GI surgery presents unique technical challenges. The oesophagus and upper stomach are surrounded by delicate structures, and surgical access is often limited.
Robotic technology can be particularly advantageous in this setting by providing:
Enhanced visual clarity in deep or narrow operative fields
Greater precision during fine dissection and reconstruction
Reduced tissue handling, which may support smoother recovery
Improved ergonomics for the surgeon, helping maintain consistency during longer procedures
For selected patients with complex benign Upper GI conditions, these factors can make robotic surgery a valuable option.
The introduction of robotic surgery into my practice followed a structured and carefully supervised pathway.
This included:
Formal robotic assessment and technology training
Proctored initial robotic cases
A graduated progression from simpler procedures to more complex Upper GI operations
Ongoing audit and reflection on outcomes
To date, I have performed close to 100 robotic Upper GI procedures. These include robotic cholecystectomies as well as complex operations involving the oesophagus and stomach, such as oesophageal and gastric resections for benign disease.
Equally important to me is the role of training. Robotic surgery is not only about individual practice, but also about developing safe and sustainable programmes that support trainees and future consultants.
From the patient’s perspective, robotic Upper GI surgery is intended to reduce the physical impact of surgery while maintaining safety and effectiveness.
Potential benefits may include:
Smaller incisions compared with open surgery
Reduced post-operative discomfort
Shorter hospital stays
Faster return to everyday activities
Recovery depends on the individual patient and the specific procedure performed. Robotic surgery is not appropriate for every case, and careful assessment is essential to determine whether it offers a genuine benefit.
For patients considering robotic Upper GI surgery, it is important to understand:
The surgeon’s specific experience with robotic Upper GI procedures
Whether robotic surgery is being used selectively and appropriately
How decisions are made between robotic, laparoscopic, and open approaches
My approach is to recommend robotic surgery only when it is clearly suited to the patient’s condition and offers a meaningful advantage.
