Perceptions of Clinical Healthcare Providers Regarding Robotic-Assisted Surgery (RAS) in Surgical Practice: A Qualitative Systematic Review

Abstract

Background: The utilisation of robotic-assisted surgery (RAS) is expanding in modern healthcare, providing enhanced precision, ergonomic advantages and improved patient outcomes. However, the integration of this technology into surgical practice remains complex. Although healthcare providers (HCPs) hold central importance in RAS, their experiences and perceptions have yet to be examined, limiting the insights necessary to guide effective implementation strategies.

Objective: The objective of this study is to identify the key challenges HCPs face in RAS and to explore the impact of RAS on workflow, team interactions and clinical staff well-being. This is crucial to determine the key enablers for successful implementation of RAS based on perceptions and experiences of HCPs.

Method: A qualitative systematic review was conducted using SPIDER framework following PRISMA and ENTREQ guidelines to explore perceptions of HCPs regarding RAS. Six databases alongside hand searching and citation chaining were used to systematically search for peer-reviewed studies that are published within the past five years (2020-2025) and in English language with full-text availability. Additionally, focusing on studies of either qualitative or mixed-method study design with an extractable qualitative component that is about the perceptions and experiences of HCPs towards RAS. Seventeen studies were included, critically appraised using CASP checklist and used for data extraction. Thematic analysis and synthesis were used for data analysis.

Results: Three main themes and 10 sub-themes were identified indicating the following challenges: lack of structured training, technology-related stress, increased workload, and logistical or financial limitations. Additionally, the unequal access to RAS training opportunities among HCPs led to variability in skills and preparedness throughout institutions. Synthesis indicated that RAS is restructuring clinical workflows and professional identities, requiring significant facilitators including structured training, teamwork, leadership, technological advancements, and governance frameworks for successful and sustainable implementation.

Conclusion: Despite the vital clinical and technological promise of RAS, successful implementation requires structured training, supportive leadership, developed infrastructure, regulatory frameworks, and reallocation of roles and responsibilities.