Revista ABCd (São Paulo). 30 Jan, 2026

Global strategies for the diffusion of robotic surgery

Francisco TUSTUMI
Louisa BOLM
Rodrigo Camargo Leão EDELMUTH
Felipe Antonio Boff MAEGAWA
Wellington ANDRAUS
Paulo HERMAN
Tyler MCKECHNIE
Allan TSUNG
Sarah SAMREEN
Ryan MERKOW
Nigel D’SOUZA
Syed Nabeel ZAFAR
Giovanna Mennitti SHIMODA
Nelson WOLOSKER
Yoshikuni KAWAGUCHI
Georgios TSOULFAS
Eduardo Esteban MONTALVO-JAVE
Vikas DUDEJA
Puja Gaur KHAITAN
Sajid KHAN
DOI: https://doi.org/10.1590/0102-67202025000039e1908

Background:

The global adoption of robotic surgery has advanced rapidly in high-income countries, yet its diffusion remains limited in resource-constrained settings due to financial, infrastructural, and educational barriers. As surgical technology evolves, there is an urgent need to promote countries’ equitable access to robotic platforms worldwide.

Aims:

The aim of this study was to analyze global strategies employed to promote the diffusion of robotic surgery, with a particular focus on overcoming barriers in resource-limited settings, and to provide practical insights that can guide its equitable and sustainable implementation.

Methods:

This study is a multinational, policy-oriented integrative review conducted under the guidance of the Research Committee of the Society for Surgery of the Alimentary Tract in the USA (SSAT). The study integrates a bibliometric analysis, a literature review, and expert insights from diverse healthcare environments. Contributions were gathered from SSAT members.

Results:

Robotic platforms are predominantly concentrated in North America, Western Europe, and Eastern Asia, with the USA hosting nearly 60% of all installations. Research output is similarly skewed, with few countries and institutions producing most clinical trials. Key barriers to diffusion include high costs, lack of infrastructure, limited training capacity, regulatory hurdles, and resistance among surgeons. Facilitators include public–private partnerships, philanthropic support, technology transfer, simulation platforms, and curriculum integration by professional societies.

Conclusions:

Achieving global equity in robotic surgery requires coordinated action across research, education, clinical practice, policy, and infrastructure. Global cooperation and innovation in implementation strategies can help bridge the current disparities and promote safe, cost-effective surgical care in underserved regions, improving patient outcomes.


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ABCD – BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY is a periodic with a single annual volume in continuous publication, official organ of the Brazilian College of Digestive Surgery - CBCD. Technical manager: Dr. Francisco Tustumi | CRM: 157311 | RQE: 77151 - Cirurgia do Aparelho Digestivo

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