Robotic hernia repair has spread without demonstrated superiority, and its device-related adverse event reports are unstudied. We compared them with reports from other robotic procedures, prespecifying cholecystectomy as the primary comparator. Using complete US Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience files (cutoff 8 October 2026), we identified operations by prespecified narrative rules and merged 2022–2026 reports into events. Reporting odds ratios (ROR) with 95
Robotic-assisted arthroplasty improves resection accuracy, component positioning, and reproducibility. Whether these technical gains produce clinically meaningful benefits remains uncertain. This expert narrative review drew on PubMed, Embase, and Web of Science searches performed on April 28, 2026. Systematic reviews and randomized trials were prioritized, supplemented by observational, registry, economic, and technical studies. Evidence was appraised qualitatively by design, follow-up, bias, and platform differences; technical endpoints were assessed separately from patient-important outcomes. Evidence most consistently supports fewer alignment and component-positioning outliers. Functional and perioperative benefits vary by procedure, platform, outcome, and follow-up; evidence for generalizable long-term benefit remains inconsistent. The precision–target gap is proposed as one explanation: more accurate execution may yield limited benefit when the surgical target is insufficiently validated for the patient. Small differences from conventional care, confounding, and outcome measurement provide alternative explanations. Clinical value requires evidence that a surgical target improves outcomes and that robotic delivery adds benefit. Patient-specific models, intraoperative sensing, and decision support require external validation and prospective comparison with optimized conventional care. Adoption should reflect patient-important outcomes, cost-effectiveness, and local practice.
Robot-assisted surgery has transformed urological surgery, with the da Vinci Surgical System dominating for over two decades. Following the expiry of key Intuitive patents in 2019, two particular platforms - Medtronic’s Hugo™ RAS system and CMR Surgical’s Versius® Surgical Robotic System - have gained regulatory approval and entered urological practice. Comparative evidence between these platforms and da Vinci® across urological procedures remains limited. This systematic review follows PRISMA guidelines and a prospectively registered protocol (PROSPERO: CRD420261319741). MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were searched from January 2016 to August 2026. Comparative studies of Hugo™ RAS or Versius® versus da Vinci® in patients undergoing robot-assisted radical prostatectomy (RARP), robot-assisted partial nephrectomy (RAPN), pyeloplasty, or radical cystectomy were eligible. Risk of bias was assessed using ROBINS-I. 19 studies (21 procedural comparisons) involving 2,482 patients were included. In RARP, blood loss and length of stay showed substantially overlapping ranges between platforms, with no consistent direction of effect, though setup and docking times were consistently longer with the newer platforms. Positive surgical margin rates and early continence recovery overlapped widely in RARP. In RAPN, warm ischaemia times differed by five minutes or less across reporting studies, and trifecta rates were within 5 percentage points. The single small pyeloplasty study reported identical median operative times, but provided minimal comparative information. Early comparative evidence has not demonstrated consistent differences in peri-operative, oncological or early functional outcomes between Hugo™ RAS or Versius® and da Vinci® in experienced, high-volume centres. However, the included studies were small, non-randomised and not powered to detect clinically meaningful differences or to demonstrate equivalence. These findings therefore represent an absence of evidence of a difference rather than evidence of comparable effectiveness. Prospective studies including robotic-naïve centres are needed to advance our understanding.
This review evaluated the incidence, characteristics, and management of pin-related complications following robotic-assisted total knee arthroplasty (RA-TKA). MEDLINE, Embase, and CENTRAL were searched from January 1, 2010, to April 15, 2026 for studies evaluating pin-related complications following primary RA-TKA. Pooled complication rates were estimated using a random-effects generalized linear mixed model, and a random-effects Mantel-Haenszel meta-analysis compared complication rates between intra-incisional and extra-incisional tracker pin placement. Descriptive analyses summarized pin techniques, complications, and management. Thirty-seven studies comprising 15,874 RA-TKAs were included with a mean age of 65.5 years, body mass index of 30.5 kg/m², and follow-up of 10.7 months. Femoral pins were most commonly placed intra-incisionally (54.9
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.
