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Robotic-Assisted Vascular Surgery: Current Landscape, Challenges, and Future Directions.

Yaman Alsabbagh1, Young Erben1, Adeeb Jlilati1

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Journal of Clinical Medicine
|October 29, 2025
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Summary

Robotic-assisted surgery offers a durable, minimally invasive approach in vascular surgery, improving patient recovery and surgeon ergonomics. While promising, challenges like cost and training need addressing for wider adoption.

Keywords:
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Area of Science:

  • Vascular Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Vascular surgery evolved from open to endovascular techniques, each with trade-offs in invasiveness and durability.
  • Laparoscopic surgery offered minimally invasive benefits but faced limitations.
  • Robotic-assisted surgery emerges as a significant advancement, merging open surgery durability with minimally invasive recovery.

Purpose of the Study:

  • To review current evidence on robotic applications in various vascular interventions.
  • To assess the feasibility, outcomes, and future potential of robotic surgery in vascular care.

Main Methods:

  • Systematic review of current evidence on robotic vascular surgery.
  • Analysis of feasibility and outcomes across aortic, visceral, venous, and endovascular procedures.
  • Evaluation of endovascular robotics for catheter navigation and radiation exposure reduction.

Main Results:

  • Feasibility demonstrated in over 1500 patients with low conversion rates (~5%) and mortality (1-3%).
  • High long-term patency rates (>90%) reported for aortoiliac occlusive disease.
  • Endovascular robotics significantly improves navigation precision and reduces radiation exposure (85-95%).

Conclusions:

  • Robotic vascular surgery shows promising feasibility and outcomes, comparable to traditional methods.
  • Barriers to adoption include cost, instrument limitations, and training needs.
  • Future advancements like AI and augmented reality, alongside multicenter trials, are crucial for establishing robotics as a standard in vascular care.