Evidence map›Paper›PMID 36253624›Full record

ArticleSurgical endoscopy2023

The evolving use of robotic surgery: a population-based analysis.

Hala Muaddi, Therese A Stukel, Charles de Mestral, Avery Nathens, Stephen E Pautler, Bobby Shayegan, Waël C Hanna, Christopher M Schlachta, Rodney H Breau, Laura Hopkins and 2 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. A History of Cholecystectomy.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026
    Article
  2. Review
  3. RoboticJournal of thoracic disease · 2026
    Article
  4. Quality assessment of robotic repair of benign ureteral strictures A Canadian, single-center experience.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Article
  5. Article
  6. Robotic-assisted partial nephrectomy using the HugoCanadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025
    Article
  7. Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010-2019.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025
    Article
  8. Article
  9. Observational
  10. Article
  11. Article
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Hala MuaddiDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Therese A StukelInstitute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
Charles de MestralInstitute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
Avery NathensDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Stephen E PautlerDivision of Urology, Division of Surgical Oncology, Department of Surgery, Western University, London, Canada.
Bobby ShayeganJuravinski Cancer Centre, McMaster University, Hamilton, Canada.
Waël C HannaDivision of Thoracic Surgery, McMaster University, Hamilton, Canada.
Christopher M SchlachtaDivision of General Surgery, Department of Surgery, Western University, London, Canada.
Rodney H BreauDivision of Urology, Department of Surgery, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Laura HopkinsDivision of Oncology, Saskatchewan Cancer Agency, Saskatoon, Canada.
Timothy D JacksonDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Paul J KaranicolasDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada. paul.karanicolas@sunnybrook.ca.

Funding

CIHR
6 · The paper itself

Abstract

introductionRobotic surgery has integrated into the healthcare system despite limited evidence demonstrating its clinical benefit. Our objectives were (i) to describe secular trends and (ii) patient- and system-level determinants of the receipt of robotic as compared to open or laparoscopic surgery.

methodsThis population-based retrospective cohort study included adult patients who, between 2009 and 2018 in Ontario, Canada, underwent one of four commonly performed robotic procedures: radical prostatectomy, total hysterectomy, thoracic lobectomy, partial nephrectomy. Patients were categorized based on the surgical approach as robotic, open, or laparoscopic for each procedure. Multivariable regression models were used to estimate the temporal trend in robotic surgery use and associations of patient and system characteristics with the surgical approach.

resultsThe cohort included 24,741 radical prostatectomy, 75,473 total hysterectomy, 18,252 thoracic lobectomy, and 4608 partial nephrectomy patients, of which 6.21% were robotic. After adjusting for patient and system characteristics, the rate of robotic surgery increased by 24% annually (RR 1.24, 95%CI 1.13-1.35): 13% (RR 1.13, 95%CI 1.11-1.16) for robotic radical prostatectomy, 9% (RR 1.09, 95%CI 1.05-1.13) for robotic total hysterectomy, 26% (RR 1.26, 95%CI 1.06-1.50) for thoracic lobectomy and 26% (RR 1.26, 95%CI 1.13-1.40) for partial nephrectomy. Lower comorbidity burden, earlier disease stage (among cancer cases), and early career surgeons with high case volume at a teaching hospital were consistently associated with the receipt of robotic surgery.

conclusionThe use of robotic surgery has increased. The study of the real-world clinical outcomes and associated costs is needed before further expanding use among additional providers and hospitals.

Indexed as

LaparoscopyRoboticsRobotic Surgical ProceduresAdultFemaleHospitals, TeachingHumansMaleOntarioRetrospective StudiesNovel surgical technologyRobotic surgerySurgical innovation

Identifiers

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.