Towards sustainable implementation of robotic surgery: an interregional strategic framework from Norway

Robot‑assisted soft‑tissue surgery (RAS) is embedded in many healthcare systems, yet large‑scale adoption has often proceeded without coordinated governance, resulting in variation in access, training standards, and outcome reporting. This policy perspective summarises the findings and recommendations of an interregional expert group commissioned by Norway's four Regional Health Authorities to develop a strategic framework for sustainable implementation of RAS within a publicly funded specialist healthcare system. Key challenges identified include unclear indication selection, heterogeneous training standards, fragmented procurement practices, incomplete lifecycle costing, and limited systematic outcome monitoring. Core recommendations comprise prioritisation of procedures with demonstrated clinical value, standardised lifecycle cost assessment, coordinated procurement, accredited training pathways, and mandatory data registration. The Norwegian framework illustrates how governance, evidence generation, and workforce planning can be aligned to promote sustainable implementation of robotic surgery. Although developed within a public health system, several principles are transferable to other healthcare contexts.