Economic assessment of next-generation robotic surgical systems compared with the multiport da Vinci platform: a comprehensive review.

The global landscape of robotic-assisted surgery is undergoing rapid transformation as new platforms emerge to challenge the long-standing dominance of the da Vinci (DV) system. Although DV remains the most widely adopted robotic platform worldwide, its high acquisition and maintenance costs have limited diffusion, particularly in resource-constrained regions. Next-generation systems-including Hugo RAS, Versius, Senhance, Hinotori, KangDuo, Sentire, and Micro Hand S-aim to expand access through reduced capital expenditure, reusable instrumentation, alternative cost structures, and modular architectures. This narrative review synthesizes available studies comparing the economic performance of these new technologies - including da Vinci Single-Port - with the DV multiport. A systematic search across PubMed, Scopus, and Cochrane Library identified 14 comparative cost studies through October 2025. Radical prostatectomy was the most frequently evaluated procedure, with additional analyses focused on colorectal surgery, hysterectomy, sacrocolpopexy, total mesorectal excision, and pyeloplasty. Overall, emerging platforms demonstrate heterogeneous but promising economic profiles. Hugo RAS and KangDuo showed lower overall procedural expenses in some series, although early inefficiencies may increase initial non-surgical operative time until team proficiency improved. The da Vinci Single Port platform demonstrated possible cost increases relative to the multiport system, largely influenced by institutional discharge pathways and disposable pricing. Economic outcomes varied markedly across institutions, driven by local procurement policies, instrument pricing, operative workflows, and reimbursement models. Current evidence suggests that new robotic platforms can reduce specific cost components without compromising clinical outcomes, yet generalizability remains limited. Standardized, prospective cost evaluations incorporating acquisition models, non-surgical time, learning curves, and long-term outcomes are essential to determine true value across healthcare settings.