Perception and Reality of Robotic Microsurgery: A Cross-sectional Comparative User and Nonuser Survey Study.

Background: With robotic microsurgical systems (RMSs) gaining increasing interest in clinical application, user feedback is crucial for their future development. Additionally, understanding the realistic advantages and limitations of RMSs among nonusers is crucial for broader clinical adoption and appropriate patient selection. This study aimed to assess user experiences on advantages, disadvantages, necessary improvements, and future developments of RMSs and compare it to the views of nonusers on the same aspects. Methods: An international online survey was conducted among microsurgeons, assessing their views on the aforementioned aspects of RMSs. User and nonuser replies were compared and assessed for differences and similarities to draw conclusions about the experiences and expectations of both groups. Results: A total of 68 surgeon replies were included, consisting of 14 users and 54 nonusers from 17 countries. Results showed that users appreciated tremor reduction and improved anastomotic quality as advantages, which were significantly underestimated by nonusers. Nonusers overestimated potential advantages like improved access to deep structures and an increased range of motion and underestimated disadvantages like a flat learning curve. Both groups agreed on the need for technical improvements, particularly in reducing system costs and setup times. For future indications, users saw significant importance in the role of RMSs in reducing human error. Conclusions: Our findings underscore the potential of RMSs, drawing a realistic picture of real user experiences and nonuser expectations and highlighting key areas for further technological advancement before broader adoption.