Robotic surgery in Australia has been growing steadily, yet plenty of experienced, highly skilled surgeons still choose traditional or laparoscopic methods over robotic systems. This is not a sign they are behind the times.
There are genuine, well-reasoned factors behind this choice, ranging from cost and access through to a simple lack of strong evidence for certain procedures. Understanding these reasons can help you have a more informed conversation with your own surgeon about what is right for your operation, rather than assuming a traditional technique means you are getting outdated care.
The Evidence Gap
One of the biggest reasons some surgeons hold back is that the research supporting robotic surgery is not as strong as many people assume.
A Perspective published in the Medical Journal of Australia noted that finding high-quality evidence supporting robotic surgery remains challenging, with the authors pointing out that surgeons themselves are often the biggest hurdle to running the trials needed to properly test the technology, since recruiting patients for surgical trials comparing techniques is notoriously difficult.
In some cases, the evidence has actually raised concerns rather than confirmed benefits. For certain gynaecological cancer procedures, research has suggested a robotic-assisted approach may lead to worse outcomes than traditional surgery, which is a serious reason for caution.
New Technology Does Not Always Mean Better Outcomes
It is easy to assume that newer, more advanced technology automatically produces better results, but that is not always the case in surgery. Many surgeons prefer to wait for solid evidence before adopting a new approach, rather than switching simply because a technology is available.
Sticking With a Technique They Have Mastered
Many surgeons have spent years, sometimes decades, refining their skill with laparoscopic or open techniques, and their outcomes with these methods can be excellent.
Switching to a robotic system means starting back at an earlier point on the learning curve for that particular technology, even for a highly experienced surgeon. For a surgeon who already achieves strong results with their current approach, this trade-off is not always worthwhile, particularly for procedures where robotic benefits are not clearly proven.
The Cost of Robotic Systems
Robotic surgery is expensive, and this shapes which hospitals and surgeons have access to it in the first place.
In Australia, a single da Vinci Xi robotic platform is estimated to cost around $3.9 million, with additional consumable costs of roughly $1,848 per operation and a three year service contract costing several hundred thousand dollars on top of that.
These costs are a major reason robotic systems are concentrated in certain hospitals rather than being universally available, and why some surgeons who trained on traditional or laparoscopic techniques simply do not have regular access to a robotic system.
Access Is Not Even Across Australia
Even where the evidence and willingness exist, physical access to a robotic system is a genuine barrier for many surgeons.
According to a Royal Australasian College of Surgeons report, as of May 2023, 84 per cent of robotic platforms in Australia were located in private hospitals, which limits access for patients relying on the public system and for the surgeons working within it.
Public hospitals also face a funding structure where procedures are reimbursed at a set rate regardless of technique, which can reduce the financial incentive to invest in robotic systems in the first place. This structural issue affects surgeons working in the public system regardless of their personal interest in the technology.
The Learning Curve for Surgeons
Skill with a robotic system does not happen overnight, and this is a genuine consideration for both surgeons and patients.
As one Australian surgical resource explains, a surgeon new to robotic systems will typically have longer procedure times and potentially different outcomes compared to a highly experienced robotic surgeon, which is why asking about a surgeon’s specific experience with robotic techniques is a reasonable question to raise.
- Specialised training is required beyond standard surgical qualifications
- Operating room staff also need training to support robotic procedures
- Experienced surgeons in traditional techniques may see limited benefit in retraining for procedures they already perform well
Not Every Procedure Suits a Robotic Approach
Robotic surgery has proven genuinely valuable for some procedures, particularly prostate surgery, but its benefits are far less established for others.
Many colorectal and gynaecological procedures, for example, remain commonly performed using laparoscopic or open techniques, since the evidence for a meaningful advantage from robotic surgery in these areas is still developing.
A skilled surgeon choosing a traditional approach for these procedures is often making a well-informed clinical decision, not avoiding modern technology out of habit. As more research is published and newer robotic systems enter the market, this balance may well shift over time.
What This Means for You as a Patient
If your surgeon recommends a traditional or laparoscopic approach over a robotic one, it does not necessarily mean you are missing out.
It is entirely reasonable to ask your surgeon why they have recommended a particular technique, what their experience is with it, and whether a robotic option is available and appropriate for your specific procedure. A good surgeon will be happy to explain their reasoning and will not be offended by the question.
Conclusion
Surgeons who choose not to use robotic systems are often making a considered decision based on evidence, cost, access or their own clinical experience, rather than resisting progress. As competition between robotic platforms increases, costs potentially fall, and more research emerges, this picture is likely to keep evolving over the coming years.
If you are curious about whether robotic surgery is suitable for your procedure, the best step is to ask your surgeon directly. You can also visit surgery.com.au to find surgeons and specialists across major Australian cities and read more articles on surgical technology and care.
FAQs
1. Does choosing a non-robotic surgeon mean I am getting worse care?
No. Many surgeons choose traditional or laparoscopic techniques based on strong clinical evidence and years of personal expertise, particularly for procedures where robotic benefits are not clearly established in the research.
2. Why is robotic surgery so expensive in Australia?
Robotic systems involve significant upfront costs, ongoing consumable expenses and multi-year service contracts, which is one reason they are more common in private hospitals than public ones with fixed procedure funding.
3. Is robotic surgery available in public hospitals?
Yes, but access is more limited than in the private system, since a large majority of robotic platforms in Australia are currently located in private hospitals rather than public ones.
4. Is robotic surgery always better than traditional surgery?
Not necessarily. Its benefits are well supported for some procedures, such as prostate surgery, but less established for others, and in a small number of cases research has raised concerns rather than confirmed an advantage.
5. Can I ask my surgeon about their robotic surgery experience?
Yes. Asking about a surgeon’s experience with a specific technique, including robotic surgery, is a reasonable and encouraged question when deciding on your treatment plan.