Worldwide diffusion of robotic approach in general surgery.

The robotic system has overcome some laparoscopic shortcomings, such as stereoscopic 3D-magnified vision, a stable camera and flexible and tremor filtering manipulation. Therefore, robotic surgery has made many steps forward gaining more diffusion in the field of general surgery and this trend was associated with a decrease in laparoscopic surgery. Although the safety and effectiveness of robotic surgical systems in most procedures has been confirmed, some difficult procedures have not been widely performed but rather limited to a few highly specialized centers. This study describes the worldwide diffusion of robotic surgery in their respective fields in terms of hepatectomy, gastrectomy, esophagectomy, colectomy and pancreatectomy, respectively. The worldwide diffusion of robotic surgery is uneven, which may be related to the local economic strength, government health care policies, and surgeons' preference for minimally invasive surgery of various countries and regions. In the future, with the gradual decrease of cost of robotic surgical systems, and the standardization of surgical procedures, as well as the coverage of medical insurance, we believe that robotic surgery will become the gold standard procedure in general surgery.