Awareness, perception, knowledge, and attitude toward robotic surgery in a general surgical outpatient clinic in Singapore, Asia

Robotic surgery is an advancing technology and patients may not be fully aware of these advancements. Social media and advertisements may falsely skew patients' understanding. This study aims to seek awareness, understanding. and attitude toward robotic surgery in Singapore.

A cross-sectional study of 472 patients and/or their relatives (response rate 94.4%) in a specialist outpatient clinic chosen through convenience sampling from May to July 2017 was performed. All healthcare workers or participants <21 years of age were excluded. A 19-point survey questionnaire including patient sociodemographics and awareness and attitudes toward robotic surgery was administered. Univariate and multivariate analysis was performed to assess participants' preference for robotic surgery.

Two hundred and sixty (55.1%) of the participants were female and the majority were aged 21-40 years old (55.5%). 250 participants (53.0%) reported having heard of robotic surgery; majority (n=205, 82.0%) were from the media. Two hundred and six (43.6%) participants had the misconception that robotic surgery involved an automated robot. Multivariate analysis showed that perception that robotic surgery yielded better results was independently associated with preference for robotic surgery (prefers robotic surgery: n=56/159 (35.2%), do not prefer robotic surgery: n=81/313 (25.9%), odds ratio (OR) 1.61, 95% confidence interval (CI): 1.06-2.45, P=0.026). Having concerns that wrong surgery may be performed by robotic surgery were also independently associated with disinclination toward robotic surgery (OR 0.51 [95% CI: 0.35-0.76], P=0.001).

Understanding of robotic surgery was poor with several misconceptions. It is paramount to clarify these misconceptions to advocate for informed decision-making.

Measures need to be taken to ensure adequacy of pre-operative counseling in patients undergoing robotic surgery. Misconceptions on benefits and risks of robotic surgery should be cleared before decision on the surgical access and approach.