Hospitals that acquire robotic-assisted surgery (RAS) platforms often seek to increase utilization, yet surgeons and operating-room teams bear the learning, coordination, and early efficiency costs of adoption. This scoping review mapped evidence on hospital incentives and broader implementation support for appropriate surgeon adoption of RAS. Following JBI guidance and a registered protocol, we searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and IEEE Xplore to September 2026, supplemented by Google Scholar and citation searching, and reported findings following PRISMA-ScR. Two reviewers independently screened 1,058 records and included 17 sources (12 empirical studies; five reviews or recommendation documents). No included source evaluated a hospital incentive program, so the evidence was indirect. Nine of the 12 empirical studies used US data, and none linked incentive or support exposure to the appropriateness of patient selection or to patient outcomes. Industry payments were associated with greater robotic use; one observational evaluation linked proficiency-based training with shorter operative times and lower unadjusted costs; and qualitative studies identified barriers related to training, staffing, operating access, and credentialing. Using the capability, opportunity, and motivation (COM-B) model to organize these findings, we propose a four-layer framework (clinical justification, capability, operating opportunity, and governance), map the evidence to each layer, and specify a minimum configuration for hospitals with limited resources. The framework is a set of testable proposals, not a validated intervention. Hospital support appears most defensible when it addresses a documented barrier within a clinically justified service, and robotic case volume alone does not adequately measure program success.
Robot-assisted suturing requires precise technical skills and objective assessment methods to support training. This study aimed to define an objective Performance Score for simulated robot-assisted suturing and to examine practice-related changes within each cohort. Six suturing scenarios ordered according to experts’ perceived difficulty were implemented in a simulated training environment. Ten expert surgeons (out of 11 enrolled) completed the six scenarios once using the da Vinci Research Kit simulator; afterwards, they completed 20 repetitions of Scenario 4. Twenty-two residents (out of 25 enrolled) performed a training task in which they repeated the same scenario until they achieved a Performance Score > 75 < 0.001). Experts also showed time differences between scenarios (p = 0.044), and time reduction with practice (p < 0.001), while accuracy and errors remained stable. Residents improved the Performance Score from 74 ± 7 ± 3 < 0.001) and greater accuracy (p < 0.001). The proposed Performance Score and suturing simulations are objective tools for training and assessing robot-assisted suturing skills. The findings provide evidence for composite performance indicators that capture multiple dimensions of technical performance and therefore can support personalized and adaptive surgical training programs.
We examined institutional operative-time trends during single-port robot-assisted partial nephrectomy (SP-RAPN) adoption across RENAL complexity strata. Methods: This retrospective six-center cohort included 408 procedures with available RENAL scores. Operative time was analyzed against institutional case sequence using center fixed-effects models, institution-clustered confidence intervals, and wild-cluster bootstrap tests. Results: For RENAL 4–9 tumors, slopes were negative at all six institutions. The pooled estimate was − 0.64 min/case (95
Robotic surgery is increasingly integrated into surgical practice, yet structured, benchmark-driven simulation training remains limited for general surgery trainees. Proficiency-based progression (PBP) offers a practical, specialty-tested approach for structuring robotic surgical training around demonstrated performance rather than case numbers, but standardized PBP curricula for general surgery robotic training remain underdeveloped. This study aimed to test the feasibility of a structured, simulation-based robotic training and, building on this, to develop a preliminary proficiency-based approach whose benchmarks can be formally evaluated in future studies. We conducted a prospective, single-center pilot feasibility study of a structured robotic simulation curriculum over two weeks, combining virtual reality simulation and dry-lab training on the da Vinci Xi system (Intuitive Surgical, Sunnyvale, CA, USA). Advanced and novice robotic surgeons completed stepwise training sessions targeting core robotic skills and procedural tasks. Feasibility was defined by successful implementation within the timeframe, completion of sessions, and participant acceptance, assessed informally; the curriculum was subsequently structured into skill modules with proposed proficiency benchmarks. The curriculum was successfully implemented within the planned two-week timeframe, with six advanced and fifteen novice robotic surgeons participating. The curriculum was structured into six sequential modules, representing key technical and non-technical skills in robotic surgical practice, each with proposed proficiency benchmarks. This pilot study demonstrates the feasibility of a structured robotic simulation curriculum in general surgery. The proposed benchmark-driven structure may inform the development of standardized robotic simulation curricula for general surgery training programs, pending further validation against clinical performance.
This study estimated the impact of robotic-assisted surgery (RAS) versus laparoscopy (LPS) on operating time (OT), length of hospital stay (LOHS), and examined mediation through perioperative factors. A secondary analysis of individual patient data from a retrospective multicenter study was conducted. Women with histologically confirmed stage I endometrial cancer (EC) undergoing hysterectomy between January 2010 and December 2023 were included. After inverse probability of treatment weighting (IPTW), baseline covariates achieved standardized mean differences below 0.10. The IPTW-weighted effect estimate of LPS relative to RAS, interpreted as an adjusted association under the assumption of no unmeasured confounding was, 31.4 min for OT (95
