Global utilization and clinical outcomes of robotic abdominal surgery in Western vs Eastern Countries: an expanded systematic review and meta-analysis.

Robotic-assisted abdominal surgery, particularly with the da Vinci system, has seen increasing global use, though adoption remains uneven between Western and Eastern countries. This systematic review and meta-analysis examined global utilization trends, clinical outcomes, and economic impact using data from PubMed, EMBASE, and the Cochrane Library (2009-2025). Sixty-two studies involving approximately 250,000 patients were included. Findings show faster adoption in Western countries, rising from 2 to 16% of procedures between 2012 and 2018, compared to slower growth in Eastern regions, from 1% to around 8-10% by 2021. Robotic surgery was associated with reduced estimated blood loss, shorter hospital stays, and fewer conversions to open procedures in both regions. However, costs were significantly higher, particularly in Western centers. Emerging robotic platforms demonstrated similar outcomes at lower costs. Robotic abdominal surgery offers consistent perioperative advantages, yet economic and infrastructural disparities continue to limit equitable global access. Strategies to expand affordable platforms and training are essential to address this gap.