London Robotic Breast Institute

Patient information on robotic-assisted breast reconstruction in the UK

Robotic breast surgery in the UK

The UK has busy robotic surgery programmes in other specialties. For the breast, two tracks must be kept apart: robotic DIEP reconstruction, which has been reported in the NHS, and robotic nipple-sparing mastectomy, which does not currently have a national programme.12

Reconstruction: a reported NHS milestone

In March 2026, Royal Free London and Hillingdon reported a robotically assisted DIEP flap reconstruction — the first UK case in those press sources.1 There is not yet a peer-reviewed UK medical paper on this case.

Mastectomy robotics and NICE guidance

Robotic nipple-sparing mastectomy (RNSM) is a different operation. It has published activity in parts of Europe and East Asia, but there is currently no UK national RNSM programme.25

In April 2025, the National Institute for Health and Care Excellence (NICE) published early value assessment guidance (HTG742) for robot-assisted soft tissue procedures, which includes breast surgery.4 NICE conditionally recommended these systems for use in the NHS only while further evidence is generated over three years.

The Association of Breast Surgery’s 2021 oncoplastic guide covers conventional nipple-sparing mastectomy. It does not endorse a robotic approach.3

An international expert consensus treats RNSM as promising but still evolving, and says long-term cancer outcomes are not yet established.2 That consensus is background only. It is not UK guidance, and it is not evidence about DIEP reconstruction.

What this means if you are a patient

Ask your team which operation they mean — reconstruction harvest, or mastectomy — and what they are offering in the NHS or privately. Availability of robotic DIEP harvest is limited. Standard DIEP reconstruction remains the usual autologous option.

Also on this site

Sources & guidance

Numbers and claims on this page have a numbered source. Open a number in the text or below to read it.

  1. pressRoyal Free London NHS Foundation Trust. A UK first for robotic reconstruction surgery. 2026 royalfree.nhs.ukNote: Press-reported UK robotic DIEP reconstruction milestone (March 2026).
  2. consensusRyu JM, Mok CW, Toesca A, Lai HW, et al. (GBCC/IERBS 2024 expert panel). Consensus statement on robotic nipple-sparing mastectomy. J Breast Cancer. 2025 doi:10.4048/jbc.2025.0030Note: Background only: RNSM evolving; long-term outcomes not established — not DIEP evidence.
  3. guidanceAssociation of Breast Surgery (ABS). Oncoplastic breast surgery: a guide to good practice. ABS. 2021 associationofbreastsurgery.org.ukNote: UK oncoplastic context; no robotic nipple-sparing mastectomy endorsement.
  4. guidanceNational Institute for Health and Care Excellence (NICE). Robot-assisted surgery for soft tissue procedures: early value assessment (HTG742). NICE. 2025 nice.org.ukNote: Conditional recommendation for robotic soft tissue surgery in the NHS during a 3-year evidence generation period.
  5. journal articlePluta P, Rathat G, Blay L, et al. Minimal access nipple-sparing mastectomy — the current European landscape. Menopause Review / Przegląd Menopauzalny. 2025 doi:10.5114/pm.2025.150082Note: Six-country expert survey (UK not included).