GROWING ROLE OF ROBOTIC-ASSISTED SURGERY IN ADULT PATIENTS - A COMPREHENSIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.1(49).2026.4938Keywords:
Robotic-Assisted Surgery, Minimally Invasive Surgery, Surgical Ergonomics, Medical RoboticsAbstract
Introduction: Robotic-Assisted Surgery (RAS) has transitioned from a technological curiosity to a foundation of modern surgery in the last few years. This review aims to evaluate the current status, clinical outcomes, economic implications, and expanding indications of RAS in adult patients across urologic, gynecologic, colorectal, and general surgical disciplines.
Methods: A review of the literature was conducted using PubMed, Scopus, and Web of Science databases for English-language articles published up to 2025. The analysis focused on randomized controlled trials (RCTs), systematic reviews, and large-cohort meta-analyses comparing RAS with open surgery and conventional laparoscopy.
Results: The analysis indicates that RAS offers superior visualization and improved ergonomics compared to conventional laparoscopy. In urology, RAS has become the gold standard for prostatectomy, showing statistically significant reductions in estimated blood loss (EBL) and improved functional recovery (continence and potency). In gynecology and general surgery, RAS demonstrates lower conversion rates to open surgery, particularly in obese cohorts and deep pelvic dissections. While operative times are frequently longer during the learning curve, total length of hospital stay is consistently reduced.
Conclusions: Robotic surgery has proven advantageous in minimizing patient trauma and assisting with complex cases where conventional laparoscopy struggles. The primary barrier remains the high upfront cost; however, these expenses may be offset over time by reduced length of stay and lower complication rates, strengthening the economic case for RAS.
References
Carbonell, A. M., Warren, J. A., Prabhu, A. S., Bessa, S. S., Phillips, S., & Cobb, W. S. (2018). Robot-assisted retromuscular ventral hernia repair: A systematic review and meta-analysis of perioperative outcomes. Annals of Surgery, 267(4), 623–631. https://doi.org/10.1097/SLA.0000000000002517
Yaxley, J. W., Coughlin, G. D., Chambers, S. K., Dunglison, N., Occhipinti, S., Samaratunga, H., ... Gardiner, R. A. (2016). Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: Early outcomes from a randomised controlled phase 3 study. The Lancet, 388(10049), 1057–1066. https://doi.org/10.1016/S0140-6736(16)30592-X
Jayne, D., Pigazzi, A., Marshall, H., Croft, J., Corrigan, N., Copeland, J., ... Brown, J. (2017). Effect of robotic-assisted vs. conventional laparoscopic surgery on risk of conversion to open laparotomy among adults undergoing resection for rectal cancer: The ROLARR randomized clinical trial. JAMA, 318(16), 1569–1580. https://doi.org/10.1001/jama.2017.7219
Ramirez, P. T., Frumovitz, M., Pareja, R., Lopez, A., Vieira, M., Ribeiro, R., ... Isla, D. (2018). Minimally invasive versus abdominal radical hysterectomy for cervical cancer. New England Journal of Medicine, 379(20), 1895–1904. https://doi.org/10.1056/NEJMoa1806395
Boggi, U., Amorese, G., Vistoli, F., Caniglia, F., De Lio, N., Perrone, V., ... Mosca, F. (2016). Laparoscopic pancreaticoduodenectomy: A systematic review and meta-analysis. Surgical Endoscopy, 30(5), 1739–1753. https://doi.org/10.1007/s00464-015-4436-5
Cerfolio, R. J., Ghanim, A. F., Dylewski, M., Veronesi, G., Spaggiari, L., & Park, B. J. (2018). The long-term survival of robotic lobectomy for non-small cell lung cancer: A multi-institutional study. The Journal of Thoracic and Cardiovascular Surgery, 155(2), 778–786. https://doi.org/10.1016/j.jtcvs.2017.09.016
Ran, L., Jin, J., Xu, Y., Bu, Y., & Song, F. (2014). Comparison of robotic surgery with laparoscopy and open surgery for rectal cancer: A meta-analysis. PLOS ONE, 9(2), e88904. https://doi.org/10.1371/journal.pone.0088904
Mottrie, A., Ficarra, V., & Buffi, N. M. (2018). Robotic partial nephrectomy: Key technical steps and outcomes. European Urology, 73(6), 882–883. https://doi.org/10.1016/j.eururo.2017.11.026
Flynn, J., Larach, J. T., Kong, J. C., Warrier, S. K., & Heriot, A. (2021). Robotic versus laparoscopic ventral rectopexy: A systematic review and meta-analysis. Colorectal Disease, 23(7), 1620–1631. https://doi.org/10.1111/codi.15615
Sheet, N., Klionsky, J., Lu, B., Chen, Q., Chen, I. G., & Varghese, T. K. (2019). Cost-effectiveness of robotic-assisted versus video-assisted thoracoscopic surgery for early-stage lung cancer. The Annals of Thoracic Surgery, 107(6), 1729–1736. https://doi.org/10.1016/j.athoracsur.2019.01.077
Novara, G., Catto, J. W., Wilson, T., Mottrie, A., & Menon, M. (2015). Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. European Urology, 68(3), 365–367. https://doi.org/10.1016/j.eururo.2015.02.042
Zihni, A. M., Cavallo, J. A., Irene-Dignam, F., Ohu, I., & Cho, S. (2018). Ergonomic analysis of robotic versus laparoscopic surgical skills: A randomized controlled trial. Journal of Surgical Research, 223, 284–291. https://doi.org/10.1016/j.jss.2017.11.028
Yeung, C., Dauterive, F., & Yeung, P. (2020). Robotic-assisted laparoscopic hysterectomy in obese patients: A systematic review. Journal of Obstetrics and Gynaecology Canada, 42(4), 509–517. https://doi.org/10.1016/j.jogc.2019.08.014
Oh, D. S., Reddy, R. M., Gorrepati, M. L., Megeno, K., & Minnillo, B. J. (2017). Robotic-assisted, video-assisted thoracoscopic, and open lobectomy: Propensity-matched analysis of recent trends. The Annals of Thoracic Surgery, 104(5), 1733–1740. https://doi.org/10.1016/j.athoracsur.2017.06.020
Rosen, M. J., Petro, C. C., & Prabhu, A. S. (2020). Robotic abdominal wall reconstruction: Management of the ventral hernia. Surgical Clinics of North America, 100(2), 391–403. https://doi.org/10.1016/j.suc.2019.12.009
Lim, P. C., Kang, E., & Park, D. H. (2016). A comparative analysis of total laparoscopic hysterectomy versus robot-assisted hysterectomy. Journal of Robotic Surgery, 10(4), 329–335. https://doi.org/10.1007/s11701-016-0598-6
Wee, I. J., Kuo, L. J., & Ngu, J. C. (2020). Complete mesocolic excision: Comparison between robotic and laparoscopic approaches. International Journal of Colorectal Disease, 35(10), 1841–1849. https://doi.org/10.1007/s00384-020-03657-3
Peters, B. S., Armijo, P. R., Krause, C., Choudhury, S. A., & Oleynikov, D. (2018). Review of emerging surgical robotic technology. Surgical Endoscopy, 32(4), 1636–1655. https://doi.org/10.1007/s00464-018-6079-2
Prete, F. P., Pezzolla, A., Prete, F., Testini, M., Marzaioli, R., Patrone, L., ... Strippoli, G. F. (2018). Robotic versus laparoscopic minimally invasive surgery for rectal cancer: A systematic review and meta-analysis of randomized controlled trials. Annals of Surgery, 267(6), 1034–1046. https://doi.org/10.1097/SLA.0000000000002523
Tam, M. S., Kaoutzanis, C., Mullard, A. J., Regenbogen, S. E., & Franz, M. G. (2016). A population-based study comparing laparoscopic and robotic outcomes in colorectal surgery. Surgical Endoscopy, 30(2), 455–463. https://doi.org/10.1007/s00464-015-4218-0
Herron, D. M., & Marohn, M. (2008). SAGES-MIRA robotic surgery consensus group: A consensus document on robotic surgery. Surgical Endoscopy, 22(6), 1386–1400. https://doi.org/10.1007/s00464-008-9926-6
Cirocchi, R., Boselli, C., Santoro, A., Valentini, V., Di Rocco, G., & Trastulli, S. (2013). Current status of robotic bariatric surgery: A systematic review. BMC Surgery, 13, 53. https://doi.org/10.1186/1471-2482-13-53
Lawrie, C. M., Nunnery, M. A., & Brooks, J. T. (2018). The learning curve in robotic surgery: A review of the literature. Current Urology Reports, 19(11), 94. https://doi.org/10.1007/s11934-018-0846-3
Chen, R., Liang, Y., Zhang, L., & Jiang, N. (2016). Robotic versus laparoscopic gastrectomy for gastric cancer: A systematic review and meta-analysis. Medicine, 95(16), e3434. https://doi.org/10.1097/MD.0000000000003434
Ficarra, V., Novara, G., Rosen, R. C., Artibani, W., Carroll, P. R., Costello, A., ... Patel, V. R. (2012). Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. European Urology, 62(3), 405–417. https://doi.org/10.1016/j.eururo.2012.05.045
Maeso, S., Reza, M., Mayol, J. A., Blasco, J. A., Guerra, M., Andradas, E., & Plana, M. N. (2010). Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: A systematic review and meta-analysis. Annals of Surgery, 252(2), 254–262. https://doi.org/10.1097/SLA.0b013e3181e6239e
Agcaoglu, O., Aliyev, S., Karabulut, K., Mitchell, J., Siperstein, A., & Berber, E. (2012). Robotic versus laparoscopic resection of gastric GISTs. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 22(5), 446–450. https://doi.org/10.1097/SLE.0b013e3182633f8e
Holtzman, S., Talamini, M., & Horgan, S. (2011). Robotics in advanced gastrointestinal surgery: The bariatric experience. Surgical Clinics of North America, 91(4), 841–855. https://doi.org/10.1016/j.suc.2011.04.010
Kelles, A., Van Herck, G., Francart, J., & Laasman, J. M. (2021). The cost-effectiveness of robotic-assisted surgery: A systematic review. Health Economics Review, 11, 23. https://doi.org/10.1186/s13561-021-00321-6
Pineda-Solorio, A., Jimenez-Vazquez, E., & Villeda-Sandoval, C. (2022). Ergonomics in laparoscopic and robotic surgery: A narrative review. Journal of Minimal Access Surgery, 18(3), 333–339. https://doi.org/10.4103/jmas.JMAS_253_20
Bailey, J. G., Hayden, J. A., Davis, P. J., & Johnson, P. M. (2014). Robotic versus laparoscopic Roux-en-Y gastric bypass in obese adults: A systematic review and meta-analysis. Surgical Endoscopy, 28(12), 3298–3310. https://doi.org/10.1007/s00464-014-3617-y
Truin, W., Jongen, A. C., & van der Heijden, J. A. (2017). Laparoscopic versus robotic total mesorectal excision for rectal cancer: A meta-analysis. Colorectal Disease, 19(5), 418–428. https://doi.org/10.1111/codi.13601
Juo, Y. Y., Sanaiha, Y., & Benharash, P. (2019). Trends in utilization of robotic-assisted surgery for common surgical procedures in the United States. Journal of Surgical Research, 239, 219–226. https://doi.org/10.1016/j.jss.2019.02.019
Bonjer, H. J., Deijen, C. L., Abis, G. A., Cuesta, M. A., van der Pas, M. H., de Lange-de Klerk, E. S., ... COLOR II Study Group. (2015). A randomized trial of laparoscopic versus open surgery for rectal cancer. New England Journal of Medicine, 372(14), 1324–1332. https://doi.org/10.1056/NEJMoa1414882
Montorsi, F., Wilson, T. G., Rosen, R. C., Ahlering, T. E., Artibani, W., Badlani, G. H., ... Patel, V. (2012). Best practices in robot-assisted radical prostatectomy: Recommendations of the Pasadena Consensus Panel. European Urology, 62(3), 368–381. https://doi.org/10.1016/j.eururo.2012.05.057
Köckerling, F. (2019). Robotic vs. laparoscopic inguinal hernia repair: A systematic review. Frontiers in Surgery, 6, 16. https://doi.org/10.3389/fsurg.2019.00016
Barbash, G. I., & Glied, S. A. (2010). New technology and health care costs—The case of robot-assisted surgery. New England Journal of Medicine, 363(8), 701–704. https://doi.org/10.1056/NEJMp1006602
Maier-Hein, L., Vedula, S. S., Speidel, S., Navab, N., Kikinis, R., & Park, A. (2017). Surgical data science for the next generation of interventional healthcare. Nature Biomedical Engineering, 1(9), 691–696. https://doi.org/10.1038/s41551-017-0132-7
Hung, A. J., Chen, J., Che, Z., Nissen, N., & Gill, I. S. (2018). Utilization of machine learning for automated performance assessment of vesicourethral anastomosis in robotic radical prostatectomy. Surgical Endoscopy, 32(1), 443–450. https://doi.org/10.1007/s00464-017-5735-8
Porpiglia, F., Fiori, C., Checcucci, E., Amparore, D., & Bertolo, R. (2018). Augmented reality robot-assisted radical prostatectomy: Preliminary experience. Urology, 115, 184. https://doi.org/10.1016/j.urology.2018.01.006
Acemoglu, A., & Martin-Gomez, A. (2020). The potential of 5G technology for remote robotic surgery: A review. IEEE Reviews in Biomedical Engineering, 14, 154–166. https://doi.org/10.1109/RBME.2020.2986798
Kneuertz, P. J., et al. (2025). Force in robotic thoracic surgery: A one-year analysis of DaVinci 5 force feedback. Journal of Robotic Surgery, 19(1), 632. https://doi.org/10.1007/s11701-025-02781-9
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Copyright (c) 2026 Anna Kocik, Ilona Tadulewicz, Natalia Nowak, Mateusz Drozd, Aleksandra Kozłowska, Zuzanna Butkowska, Łucja Komisarczyk, Tadeusz Kornela, Aleksandra Góralska, Zofia Gorzoch-Burduk

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