Perception-reality gap profiles in robot-assisted gynecologic surgery: implications for preoperative counseling among...

Robot-assisted gynecologic surgery (RAGS) is increasingly used in China, but public understanding of its value relative to conventional laparoscopic surgery (LS) may diverge from clinical evidence. This divergence may affect women's behavioral intention toward RAGS and create challenges for preoperative counseling. This study combined survey data from 546 Chinese adult women with a procedure-specific institutional benchmark derived from 536 radical hysterectomy cases at a tertiary hospital. Perception-reality gap (PRG) were then constructed for six perioperative outcomes, including postoperative complications, length of stay, operative time, intraoperative blood loss, surgical treatment cost, and hospitalization cost. K-means clustering and hierarchical multiple regression were performed. Four PRG profiles were identified: clinical benefit, comprehensively optimistic, comprehensively conservative, and clinically aligned profiles, accounting for 19.1%, 33.7%, 17.8%, and 29.5% of participants, respectively. Behavioral intention differed significantly across profiles. The comprehensively optimistic profile showed the highest behavioral intention, followed by the comprehensively conservative profile. This pattern suggests that women with less favorable benchmark-referenced perceptions may still remain open to robotic surgery. Hierarchical regression showed that PRG indicators had incremental explanatory value beyond demographic factors and technology acceptance-related perceptions. In the full model, the PRG indicators for hospitalization cost and length of stay were positive predictors, whereas the PRG indicator for operative time was a negative predictor. These findings suggest that PRG profiles may help surgeons and counseling teams recognize heterogeneous perceptions, calibrate expectations, and tailor counseling communication strategies.