Making robotic surgery viable and training general surgeons in the Brazilian public healthcare

Robotic surgery has become popular in recent decades and is already used in practically all surgical specialties. The increasing use of robotic systems has raised concerns about the safety of patients operated on by surgeons on a learning curve. This demand resulted in a standardized curriculum for training new surgeons. Public hospitals in Brazil possesses robotic systems, making surgical technology available to public healthcare. The relationship between funding and the healthcare model is one of the biggest obstacles to the deployment of expensive new treatments, such as the robotic system. In this prospective study, eighty patients were operated by robotic system, in a Brazilian public hospital, from March 2025 to January 2026, by eight apprentice surgeons. Data concerning demographics, intraoperative information (operation time, and post-operative findings were collected. Patients who underwent surgery were predominantly male (n = 48, 60%), with a mean age of 51 years (SD = 15; range: 19-81 years). The procedures performed were 39 inguinal hernioplasties (48.75%), followed by 31 cholecystectomies (38.75%) and other procedures accounted for 11 cases. Complications observed included seroma (n = 7), median 30 ml and without any approach required, urinary retention (n = 2), one infection of surgical site, one case of prolonged pain after hernioplasty and one conversion to open surgery due to complex inguinoscrotal hernia. Part of the financing came from the apprentice surgeon (70% of total cost), part came from the private initiative (20%), embodied in the robotic enterprise system and finally, funding from public healthcare. The median total cost for 5 inguinal hernioplasties and 5 cholecystectomies was 150000,00 reais, Brazilian currency.