Prospective cohort study investigating quality of life outcomes following multi-speciality robotic-assisted surgery

Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes. [17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures. [6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS. Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS. This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology. [20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery.[2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores. [5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.Introduction:Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities.A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes.Mixed-effects linear regressions were used to determine changes in QoL trajectories.Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS.RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.Robotic-assisted surgery (RAS) has been increasingly incorporated into surgical practice over the past two decades with increasingly complex procedures performed with a minimally invasive approach.[1] Emerging evidence suggests that RAS has clinical advantages over open or laparoscopic surgery, with respect to greater precision, lower blood loss and transfusion rates, reduced pain, shorter length of stay (LOS), lower incidence of complications and more rapid post-operative recovery. [2-5] However, RAS is associated with longer operative times, not universally available owing to capital and consumable expenditure, and requires a steep learning curve for complex robotic procedures.[6,7]Given the significant operating costs associated with the current robotic systems,[1,8] the potential impact of RAS on both clinical and patient-reported outcomes needs to be evaluated. Current evidence on quality of life (QoL) outcomes in patients undergoing RAS is limited and mixed.[7,9] Some studies found no significant differences between RAS and conventional approaches in QoL,[9-13] while others showed improvement in physical, functional and general health scores.[5,14-16] Most studies have relied on measuring outcomes with disease-specific functional assessment questionnaires[5,7,10,11] or had small sample sizes.[17-19] Some studies lacked a baseline measure of QoL or did not have a long-term post-operative follow-up.[10,11]With the increasing incorporation of RAS into practice, particularly within the public sector, more reliable evidence on QoL outcomes of RAS is needed to inform patient and health-care provider decision-making regarding the efficacy of the technology.[20] A wide spectrum of QoL should be considered to provide a global assessment of changes in patient QoL that encompasses social and emotional functioning as well as physical and mental well-being after RAS. A generic measure will also allow comparisons in QoL across a range of disease conditions and treatments. Given the goal of surgical procedures is to treat patients whilst at the same time maintaining or improving their physical outcomes,[21,22] QoL should be an important measure to be considered in the evaluation of RAS.This study aims to examine the direction and magnitude of changes in QoL outcomes for a multi-speciality cohort of consecutive patients undergoing RAS in a large public tertiary referral hospital in Sydney Australia.