Current status of robotic thoracic surgery in Spain: Results from a national survey.

INTRODUCTION

This study aimed to conduct the first national survey to characterize the current practice, training and perceived barriers associated with robotic-assisted thoracic surgery (RATS) among thoracic surgeons in Spain.

METHODS

Between February and March 2025, a nationwide electronic survey was distributed to thoracic surgeons through a scientific society. The questionnaire assessed institutional demographic variables, the volume and types of robotic procedures, perceived benefits and barriers, training models and access to the technology.

RESULTS

A total of 120 responses from thoracic surgeons representing 55 hospitals were analyzed. Among these, 103 respondents (85.8%) worked in centers with an active RATS program and were included in analyses related to robotic activity. Most respondents practiced within the public healthcare system (87.4%). Although more than 63% of RATS programs had been established for at least 2 years, only 27.2% of survey participants reported that most surgeons in their department were trained as console surgeons. At the institutional level, 69.9% indicated that all types of thoracic procedures were performed using RATS, and 31.1% reported more than 200 accumulated robotic cases. However, in over half of the hospitals, robotic surgery accounted for less than 25% of total thoracic surgical activity.

CONCLUSIONS

This study provides the first national overview of the status of RATS in Spain, highlighting its potential as well as the challenges limiting broader clinical consolidation. Standardized training, particularly among residents, and equitable access to robotic platforms have emerged as key priorities for the nationwide consolidation of RATS.