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Updated: Sep 22, 2025

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Adverse events following robotic surgery: population-based analysis.

Hala Muaddi1,2, Therese A Stukel2,3, Charles de Mestral2,3,4

  • 1Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

The British Journal of Surgery
|May 25, 2022
PubMed
Summary

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Robotic surgery shows fewer adverse events than open surgery but is similar to laparoscopic approaches. The benefits stem from minimally invasive techniques, not the robotic platform itself.

Area of Science:

  • Surgical Innovation
  • Patient Safety
  • Comparative Effectiveness Research

Background:

  • Robotic surgery adoption outpaced evidence generation for safety and efficacy.
  • Limited real-world studies exist on robotic surgery's comparative safety and benefits.

Purpose of the Study:

  • To compare the safety of robotic surgery with traditional open, laparoscopic, and thoracoscopic approaches.
  • To evaluate adverse events across common procedures where robotic surgery is utilized.

Main Methods:

  • Population-based, retrospective study in Ontario, Canada (2008-2018).
  • Included adults undergoing prostatectomy, hysterectomy, pulmonary lobectomy, or partial nephrectomy.
  • Primary outcome: 90-day total adverse events; secondary outcomes: minor/major morbidity.

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Main Results:

  • Robotic surgery demonstrated significantly fewer adverse events compared to open surgery across all procedures studied.
  • Relative risks (robotic vs. open) ranged from 0.44 (hysterectomy) to 0.80 (prostatectomy).
  • Robotic surgery showed similar adverse event rates compared to laparoscopic/thoracoscopic approaches (relative risks near 1.0).

Conclusions:

  • The robotic approach is associated with reduced adverse events relative to open surgery.
  • Robotic surgery safety is comparable to laparoscopic/thoracoscopic methods.
  • The primary benefit of robotic surgery appears to be its minimally invasive nature, rather than the specific robotic platform.