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Disparities in robot utilization in colorectal surgery: the widening gap
Andrew E Donaldson1, Sarah B Jochum1, Jimmie Knight1
1Department of Surgery, Rush University Medical Center, 1620 W. Harrison St, Chicago, IL, 60612, USA.
Surgical Endoscopy
|July 8, 2026
Summary
Access to robot-assisted colorectal surgery is not equitable. Non-White patients are increasingly less likely to receive this advanced surgical care, despite its proven benefits in reducing complications and mortality.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Health Services Research
Background:
- Robot-assisted surgery (RAS) is increasingly used in various specialties, including colorectal surgery.
- Existing data does not clarify if access to RAS is equitable across diverse patient populations.
- Understanding disparities in RAS adoption is crucial for equitable healthcare delivery.
Purpose of the Study:
- To identify factors influencing surgical approach selection in colectomy and proctectomy.
- To evaluate disparities in access to and outcomes of robot-assisted colorectal surgery from 2013-2020.
- To analyze trends in the utilization of robotic surgery among different racial and ethnic groups.
Main Methods:
- Retrospective analysis of adult patients undergoing colectomy and/or proctectomy (2013-2020).
- Data sourced from the National Surgical Quality Improvement Program (NSQIP) national database.
- Multivariate analysis employed to identify predictors of receiving robot-assisted surgery.
Main Results:
- Of 125,776 patients, 12.8% were non-White. Factors like female sex, non-White race, low BMI, and IBD were associated with decreased likelihood of RAS.
- The disparity in RAS access between White and non-White patients widened significantly from 2014 to 2020.
- Robot-assisted surgery was associated with fewer postoperative complications, serious adverse events, and lower 30-day mortality.
Conclusions:
- Significant racial and ethnic disparities persist in access to robot-assisted colorectal surgery.
- The widening gap in RAS access for non-White patients is concerning and requires urgent attention.
- Interventions are necessary to ensure equitable access to the benefits of robot-assisted surgery for all patients.
