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Abstract
Since the 1990s, minimal access surgery has been utilized in urology. In the past 15 years, robotic surgery has evolved and become a natural part of minimal access surgery. The dissemination has been fast and the opportunity of prospective trials has been missed. Nevertheless, robotic surgery has obvious benefits for the surgeon and patient. Even though the scientific evidence is not strong, robotic surgery is here to stay. However, there are lessons to learn from the implementation of the da Vinci system with regards to patient safety and prospective evaluation of the new technology. The future of surgery will include technologies derived from robotic surgery.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
Any innovation or new technology in surgery should improve the outcome.
Robotic surgery has not prevailed in neurosurgery and cardiac surgery.
Robotic surgery has been widely implemented in pelvic surgery, especially for radical prostatectomy.
During the rapid dissemination of robotic surgery, the opportunity of well-powered, randomized trials comparing robotics to standard of care was lost.
In retrospect, the rapid dissemination of robotics compromised patient safety.
Robotic surgery is established as a natural part of minimal access surgery.
New technologies for robotics are evolving and must still be properly assessed.