Robotic Surgery: Uses, Advantages, and Risks

By Wynona Jugueta on Mar 12, 2025.

What is robotic surgery?

Robotic surgery might sound like science fiction, but it's very real and is transforming how surgeries are performed today. If you’ve ever wondered what it’s like to have a robot involved in your practice, here’s the gist: robotic surgery is a form of minimally invasive surgery where a surgeon uses a computer console to control robotic arms. These robotic systems significantly enhance a surgeon’s precision, flexibility, and control, far surpassing what is possible with human hands alone (Rivero-Moreno et al., 2023).

Yet, robots are not operating on their own. The surgeon is still in charge, just seated a few feet away, guiding robotic arms using incredibly sensitive controls. A high-definition, 3D camera gives them a close-up view of the patient's insides, magnified and crystal clear. These tools allow for smaller incisions, more accurate movements, and faster healing for patients (Biswas et al., 2023).

One of the best-known systems is the da Vinci Surgical System, which has been used in thousands of surgeries since its launch in 2001. Whether it’s a delicate cardiac repair, a hysterectomy, or a prostatectomy, the da Vinci system helps surgeons perform complex robotic surgical procedures with better outcomes and fewer complications (Probst, 2023).

When to use robotic surgery?

Robotic surgery is used in various surgical specialties due to its ability to enhance precision, minimize invasiveness, and improve patient outcomes. Below are some situations where robotic-assisted surgery is preferred over traditional techniques.

Minimally invasive procedures

Robotic technology is widely used for laparoscopic surgery and other minimally invasive surgical procedures, offering advantages over conventional methods (Williamson & Song, 2022). Surgical robots allow surgeons to operate through small incisions using robotic surgical instruments, reducing trauma to surrounding tissues. This approach is commonly employed in hernia repairs, gallbladder removal, and hysterectomies. By minimizing tissue damage, robotic procedures often lead to shorter hospital stays, reduced need for pain medication, and faster recovery.

A real-life example of this benefit can be seen in the case of Mr. B, a patient diagnosed with localized prostate cancer (World Laparoscopy Hospital, 2024). He underwent a robotic prostatectomy using the da Vinci Surgical System, which gave the intuitive surgical team enhanced 3D visualization and precise control over their instruments. As a result, they were able to remove the cancerous prostate gland while preserving the delicate surrounding structures. Mr. B experienced minimal blood loss, a quick recovery, and maintained urinary continence and sexual function—outcomes that are often harder to achieve with traditional open surgery.

Complex surgical tasks

Robotic-assisted surgery is especially valuable in procedures that demand extreme precision, such as robotic cardiac surgery or microsurgery involving delicate, sub-millimeter structures. A compelling real-world example is a clinical trial conducted at Maastricht University, where 20 women with lymphedema underwent supermicrosurgery to connect tiny lymph vessels to nearby veins. Half received traditional manual surgery, while the other half were treated with the MUSA robotic system, designed explicitly for supermicrosurgical tasks.

Surgeons used foot pedals and joystick-like controls, allowing large hand movements to translate into ultra-fine robotic actions, enhancing accuracy and eliminating hand tremors. For instance, a 1-centimeter movement by the surgeon resulted in just a 0.1-millimeter motion from the robot arm. This setup enabled a level of precision beyond what human hands can achieve (Jee, 2020). The trial found that robotic-assisted surgery was not only safe and feasible but also led to slightly faster healing. It highlights how surgical robotics can perform complex procedures.

Specific conditions

Robotic surgery systems are utilized to treat various medical conditions that require enhanced surgical precision and control. In gastrointestinal surgeries, robotic techniques are used for procedures involving the colon, rectum, liver, and pancreas. Genitourinary surgeries, such as pelvic prolapse repair and fibroid removal, also benefit from the precision of robotic technology. Additionally, robotic-assisted techniques are used in orthopedic surgeries for conditions such as degenerative disk disease and scoliosis. Obesity-related procedures, such as gastric bypass and sleeve gastrectomy, also utilize robotic instruments to enhance surgical precision and accuracy.

A compelling example comes from Japan, where a 60-year-old man diagnosed with rectal cancer underwent a robotic-assisted laparoscopic surgery using the da Vinci Surgical System in January 2015 (Welp, 2023). The advanced control and visualization provided by the robotic system enabled surgeons to remove the cancerous tissue precisely. The operation was a success, and the patient experienced a smooth recovery. This case highlights how transoral robotic surgery can lead to improved outcomes and faster healing, particularly when complex procedures involving intricate anatomy are performed.

Benefits and advantages of robot-assisted surgery

Robotic-assisted surgery offers significant benefits for both patients and surgeons, making it a preferred approach for many complex surgical procedures. The advanced capabilities of robotic systems improve surgical precision, reduce complications, and enhance patient recovery.

For patients, robotic-assisted surgery typically results in less blood loss, reduced tissue trauma, and lower risks of surgical site infections. The minimally invasive nature of these procedures allows for smaller incisions, leading to shorter hospital stays and faster healing times. Patients undergoing surgeries such as neck surgery or robotic thoracic surgery often experience less post-operative pain and require fewer pain medications, improving their overall recovery experience. Additionally, smaller incisions result in minimal scarring, which is an important consideration for many individuals.

The minimally invasive nature of these procedures allows for smaller incisions, leading to shorter hospital stays and faster healing times.

Risks and disadvantages of using robots in surgery

While robotic surgical systems provide enhanced precision and control, they also pose several risks and disadvantages that must be carefully considered. These challenges affect both the technical aspects of the procedure and the patient outcomes.

One major concern is the potential for mechanical failure. Robotic surgical systems can experience malfunctions (Ferrarese et. al., 2016). Issues such as malfunctioning robotic arms, camera malfunctions, and instrument failures can disrupt procedures and necessitate a conversion to traditional surgical methods. Additionally, robotic systems lack haptic feedback, making it difficult for surgeons to accurately gauge the force applied during tissue manipulation, which increases the risk of unintentional tissue damage.

Another concern is surgical complications, including nerve injuries from prolonged patient positioning and an increased risk of errors due to incorrect system inputs. Mistakes in robotic surgery can lead to wrong-site surgeries, unintended retained foreign objects, and other serious complications. Furthermore, robotic-assisted procedures often take longer than traditional surgeries, leading to extended anesthesia times and an increased risk of anesthesia-related complications.

A comprehensive study conducted by researchers from the University of Illinois at Urbana-Champaign, MIT, and Rush University Medical Center examined safety reports from over 1.7 million robotic procedures performed in the U.S. between 2000 and 2013 (Alemzadeh et. al., 2013). The study linked robotic systems to at least 86 deaths, 410 patient injuries, and over 3,405 device malfunctions. Reported issues included broken instruments falling into patients’ bodies, electrical sparks causing burns, and system errors prolonging surgeries. While the overall incident rate was relatively low, the absolute number of complications continues to rise due to the exponential increase in the number of robotic surgeries.

The study linked robotic systems to at least 86 deaths, 410 patient injuries, and over 3,405 device malfunctions.

Despite these risks, robotic surgery still offers benefits, including faster recovery and a lower risk of infection. However, the report emphasizes the need for improved safety protocols and design innovations to reduce preventable incidents in the future.

Qualifications needed to perform robotic surgery

Surgeons must meet several educational and training requirements to perform robotic surgery safely and effectively. This involves obtaining a strong medical background, completing specialized training in robotic surgical systems, and gaining extensive hands-on experience. Below are the key qualifications needed to become a robotic surgeon.

Medical degree

A medical degree (MD or DO) is the foundational requirement for performing robotic surgery. Surgeons must complete medical school and a residency program in a relevant surgical specialty, such as general surgery, urology, gynecology, or cardiothoracic surgery. A strong background in laparoscopic and minimally invasive techniques is essential before advancing to robotic-assisted procedures.

Completion of a robotic surgery curriculum

Aspiring robotic surgeons must complete a structured robotic surgery curriculum, often required by hospitals and surgical training programs. Many institutions mandate the completion of courses like the da Vinci Surgical System training, which provides fundamental knowledge of robotic surgical systems, patient positioning, safety protocols, and procedural techniques.

Simulation training

Before performing live robotic surgery, surgeons must engage in simulation training. This involves dry lab (non-patient) and wet lab (cadaver or animal tissue) exercises that help develop proficiency in robotic-assisted techniques. Simulation-based training allows surgeons to refine their skills in controlling robotic surgical systems without compromising patient safety.

Docking and instrumentation training

Surgeons must undergo specialized training in robot docking and instrumentation handling. This involves learning how to correctly position the robotic surgical system, attach robotic instruments, and troubleshoot potential mechanical issues. Proper docking is crucial for optimizing surgical precision and minimizing complications during robotic procedures.

Hands-on experience

Gaining practical experience is essential before independently performing robotic surgery. Surgeons typically start as bedside assistants, observing and assisting in multiple robotic procedures before transitioning to the console surgeon role. Under the supervision of experienced robotic surgeons, they perform basic robotic-assisted surgeries before advancing to more complex procedures.

Main takeaways

Robotic surgery has transformed modern surgical practices by enhancing precision, improving patient outcomes, and expanding the scope of minimally invasive procedures. While robotic-assisted surgery offers numerous benefits, such as reduced blood loss, fewer complications, and shorter recovery times, it also presents challenges, including technical risks, longer operating times, and the need for extensive surgical training.

To perform robotic procedures, surgeons must meet strict qualifications, including obtaining a medical degree, completing a robotic surgery curriculum, undergoing simulation training, and gaining hands-on experience. As robotic surgical systems evolve, education and skill refinement remain essential for robotic surgeons to ensure safe and effective procedures.

Despite its complexities, robotic technology continues to shape the future of surgery, offering advanced capabilities that improve surgeon precision and patient care.

References

Alemzadeh, H., Raman, J., Leveson, N., & Iyer, R. K. (2013, November 1). Safety implications of robotic surgery: A study of 13 years of FDA data on da Vinci surgical systems. https://www.researchgate.net/publication/280157947_SAFETY_IMPLICATIONS_OF_ROBOTIC_SURGERY_A_STUDY_OF_13_YEARS_OF_FDA_DATA_ON_DA_VINCI_SURGICAL_SYSTEMS

Biswas, P., Sikander, S., & Kulkarni, P. (2023). Recent advances in robot-assisted surgical systems. Biomedical Engineering Advances, 6, Article 100109. https://doi.org/10.1016/j.bea.2023.100109

Ferrarese, A., Pozzi, G., Borghi, F., Marano, A., Delbon, P., Amato, B., Santangelo, M., Buccelli, C., Niola, M., Martino, V., & Capasso, E. (2016). Malfunctions of robotic system in surgery: Role and responsibility of surgeon in legal point of view. Open Medicine, 11(1). https://doi.org/10.1515/med-2016-0055

Jee, C. (2020, February 11). Robot-assisted high-precision surgery has passed its first test in humans. MIT Technology Review. https://www.technologyreview.com/2020/02/11/844866/robot-assisted-high-precision-surgery-has-passed-its-first-test-in-humans/

World Laparoscopy Hospital. (2024). Case studies: Notable successes in laparoscopic and robotic surgery. https://www.laparoscopyhospital.com/worldlaparoscopyhospital/index.php?pid=673&p=2

Probst, P. (2023). A review of the role of robotics in surgery: To DaVinci and beyond! Missouri Medicine, 120(5), 389. https://pmc.ncbi.nlm.nih.gov/articles/PMC10569391/

Rivero-Moreno, Y., Echevarria, S., Vidal-Valderrama, C., Pianetti, L., Cordova-Guilarte, J., Navarro-Gonzalez, J., Acevedo-Rodríguez, J., Dorado-Avila, G., Osorio-Romero, L., Chavez-Campos, C., Acero-Alvarracín, K., Rivero, Y., Echevarria, S., Vidal-Valderrama, C., Pianetti, L., Guilarte, J. C., Navarro-Gonzalez, J., Acevedo-Rodríguez, J., Avila, G. L. D., & Osorio-Romero, L. (2023). Robotic surgery: A comprehensive review of the literature and current trends. Cureus, 15(7), Article e42370. https://doi.org/10.7759/cureus.42370

Welp, B. (2023, December 19). Robotic surgery: Case studies & success stories. Wray Community District Hospital & Clinic. https://wrayhospital.org/robotic-surgery-case-studies-success-stories/

Williamson, T., & Song, S.-E. (2022). Robotic surgery techniques to improve traditional laparoscopy. JSLS: Journal of the Society of Laparoscopic & Robotic Surgeons, 26(2), Article e2022.00002. https://doi.org/10.4293/JSLS.2022.00002