Beyond the console: surgeon's perceptions & attitudes towards robotic surgery in Saudi Arabia: a nationwide cross-...

Robotic-assisted surgery (RAS) is increasingly adopted worldwide, yet surgeons' perceptions, training experiences, and barriers to implementation remain poorly characterized in the Gulf Cooperation Council region. We conducted the first nationwide survey of surgeons in Saudi Arabia on RAS. A 37-item questionnaire was administered to licensed surgeons across Saudi Arabia between September 2025 and May 2026, assessing training exposure, perceptions, barriers to adoption, and personal opinions. Descriptive and inferential analyses were performed. A total of 311 surgeons participated. Overall, 65.0% believed RAS improves patient outcomes and 69.5% anticipated it would become standard practice. However, only 37.0% had received formal robotic training, and 85.2% had never undergone formal proctorship - including 72.5% of surgeons actively performing robotic surgery. High acquisition cost (83.9%), limited training opportunities (76.5%), and restricted platform availability (71.7%) were the leading barriers to adoption. Although 69.5% rated current training opportunities as inadequate, 80.1% expressed interest in further education. Formal training was significantly associated with professional grade (p = 0.001) and years of experience (p = 0.005). Male surgeons were more likely than female surgeons to have received formal proctorship (18.9% vs. 5.3%; OR 4.15, 95% CI 1.58-10.86; p = 0.004). Additionally, 63.7% expressed concern that increasing RAS adoption could compromise traditional operative training.Despite strong enthusiasm for RAS, substantial deficiencies remain in structured training and proctorship in Saudi Arabia. National curricula, simulation-based education, equitable access to proctorship, and institutional investment are needed to support safe and sustainable expansion of robotic surgery.