Robotic high-intensity theater as a means to improve efficiency by increasing operative throughput: a retrospective analysis of a high-volume robotic center in the UK.

Reducing surgical waiting lists remains a key national priority for healthcare systems such as the NHS in the UK. High-intensity theater (HIT) lists, designed to increase surgical throughput by optimizing theater time and perioperative care, have been proposed as a solution. However, comparative data evaluating their safety and efficiency remain limited. To evaluate the productivity and safety of robotic HIT operating lists for benign gynecological surgery, as compared to standard weekday NHS operating lists. This was a retrospective cohort study using a prospectively maintained hospital registry. Robotic gynecological procedures performed on five HIT lists between Nov 2023 and July 2024 were compared with standard elective NHS lists during the same period. Patient demographics, operative times, complication rates, and length of stay were analyzed. A total of 194 cases were included (164 standard, 30 HIT). Case complexity was lower in the HIT cohort (p = 0.049). Mean operative time was significantly reduced in the HIT group (72.5 vs. 129.3 min, p < 0.001), with no increase in postoperative complications (13% vs. 29%, p > 0.05). HIT patients had significantly shorter hospital stays (0.4 vs. 1.2 days, p < 0.001), and comparable rates of readmission and training case involvement. HIT robotic gynecological operating lists enable efficient, safe surgical care with shorter operative times and earlier discharge, without compromising training or patient safety. Wider adoption of this model may help to reduce NHS surgical backlogs and optimize theater utilization.