Longitudinal adoption of robotic surgery and changes in prostate cancer care delivery: a 10-year institutional case...

High-cost medical technologies are usually evaluated by clinical outcomes and cost-effectiveness, while their organizational effects are less often examined. We conducted a 10-year longitudinal institutional case study (2012-2022) of 395 prostate cancer procedures, combining process tracing, descriptive quantitative trends, implementation records, and workflow documentation. Three quantitative indicators were examined across four adoption stages: procedural volume, biopsy-free surgery, and final pathological confirmation. Biopsy-free surgery increased from 13 of 55 procedures (23.6%) during experimentation to 96 of 125 (76.8%) during maturity, and final pathological confirmation increased from 22 of 55 (40.0%) to 96 of 125 (76.8%). Cochran-Armitage tests showed significant increasing trends for both indicators (Z = 6.48 and 5.25, respectively; both p < 0.001). Institutional records documented concurrent introduction of training, standardized protocols, structured assessment, multidisciplinary processes, and follow-up pathways. These findings demonstrate temporal changes in clinical practice and suggest, without quantitatively establishing, a broader evolution toward more coordinated prostate cancer care. Evaluation of high-cost technologies should therefore distinguish measured clinical changes from organizational interpretations based on implementation evidence.