Experiences with and Expectations of Robotic Surgical Systems: A Rapid Qualitative Review

Key Message

A total of 14 publications that investigated how surgical teams and patients perceive and experience robotic surgery (RS) were included in this review. All but three studies focused on the perspectives of surgical teams. 

There appears to be positive perspectives and excitement around RS and its potential. Surgical staff perceive RS to impact job roles and workflows by increasing job demands and technical knowledge. The set-up phase of RS is particularly time-consuming but is necessary to ensure patient safety and robot functions. 

There is a steep learning curve to RS, and comprehensive and uniform training and education should be required for all surgical staff engaged in RS. 

The sensory experience of RS is different from, and perhaps an improvement upon, the sensory experience of laparoscopic or open surgery. Tactile feedback is lost for surgeons in RS, creating a reliance on visual cues. The position in RS for the surgeon may be more physically comfortable than in laparoscopic or open surgery. 

Appropriate institutional conditions and support and engagement throughout the organization are required for surgical staff to engage with RS. Surgical staff require on-demand technical support for the RS to address technical issues during surgery and to alleviate stress and concerns among staff. 

Excellent surgical team dynamics, which include communication, trust, and positive relationships, are necessary to ensure effectiveness, safety, and efficiency during robotic procedures. A whole team training approach or a dedicated RS team were suggested as strategies to ensure team dynamics. 

Findings were mixed around surgical teams’ perspectives related to patient outcomes and recovery. Some participants perceived there to be positive benefits to their patients from RS while some participants did not view RS to be suitable for all patients or procedures. There were no findings related to the long-term impact of RS on patient lives or care practices. 

Patients require more information, education, and support for decision-making for RS procedures. Evidence points to a potential lack of understanding about RS and patient perspectives may differ by sex; however, due to limited published literature exploring their experiences, the patient perspective was an overall gap in this review.