Robotic Surgery: Who Benefits More, the Patient, or the Surgeon?

The adoption of robotic-assisted surgery (RAS) across multiple specialties has outpaced procedural specific evidence of benefit over laparoscopy. The question we seek to answer is not whether RAS "works"- rather whether the purported advantages are primarily for the surgeon or the patient and under what circumstances those advantages justify the added cost and complexity. With the review of randomized, trials, large comparative cohorts, cost analyses, and ergonomic studies, we hope to highlight areas where RAS delivers patient-centered value compared to surgeon benefits. Across many routine operations, with well-performed laparoscopy, patient outcomes are largely equivalent, however operative time, cost, and emerging potential safety concerns highlight the importance of a measured approach to the spread of RAS. There is evidence that RAS does offer some benefits, namely in deep pelvic dissections. Surgical approach should be based on documented outcomes, surgeon proficiency, and surgeon benefits rather than being driven by platform availability alone.