In France, as in many other countries, this discipline is gradually becoming established in operating rooms, driven by its recognized clinical benefits: enhanced precision, minimally invasive procedures, improved surgical comfort, and faster patient recovery. Yet behind this technological momentum, a major issue remains: ensuring access to appropriate, standardized, and generic training for all surgeons.

Da Vinci robot

Source: Elsan.com

In France, technological adoption is outpacing training

In France, the current limitations of robotic surgery training have been clearly highlighted by the Académie Nationale de Médecine. While the number of surgical robots installed across the country continues to rise – with more than 300 robots deployed in public and private healthcare institutions in 2025² – access to structured training remains uneven depending on institutions, regions, and specialties.

Training still largely relies on industry-dependent programs, mentorship models, or progressive learning directly in the operating room. This situation creates several challenges: unequal access, lack of standardized competencies, and increased pressure on both surgical teams and patients.

As emphasized by the Académie Nationale de Médecine, the expansion of robotics must be accompanied by standardized university curricula and recognized certification examinations to ensure high-quality initial and continuing education for surgical teams².

In emerging countries: rapid deployment of robotics… without a training ecosystem

Beyond Europe, the issue is even more pronounced in emerging countries, where robotic surgery is beginning to expand rapidly. A recent study conducted in China³ (an emerging country in the adoption of robotic surgery) highlights that, despite the rapid increase in robotic procedures, by the end of 2022 there were only two dedicated robotic surgery training centers nationwide, alongside a clear shortage of formal training programs and surgeons benefiting from structured education.

This rapid deployment faces a significant challenge: the training ecosystem is not always ready. Expert centers are rare, trained instructors are few, and mentorship opportunities are limited. In this context, reliance on occasional training sessions – often costly and difficult to replicate – slows down the effective adoption of the technology.

Democratizing training therefore becomes an issue of healthcare sovereignty: without accessible, standardized, and locally deployable solutions, robotic surgery risks remaining confined to an elite group of institutions, to the detriment of equitable access to care.

Surgery robot VERSIUS from CMR Surgical

Source: Ircad France

Robotic surgery: toward a more diversified industrial landscape

The robotic surgery market is now opening up to numerous new players, offering platforms with varied architectures, interfaces, and uses. New companies are emerging, and the use of robotics in surgery is expanding into orthopedics, endovascular procedures, neurosurgery, and beyond².

This diversification represents a major opportunity, but it also creates an unprecedented training challenge. Unlike a period dominated by a single industry player, it is now difficult – and undesirable – for training to be driven exclusively by manufacturers. As highlighted by the Académie Nationale de Chirurgie⁴, robotic surgery is entering a phase of maturity in which generic, independent, and standardized training has become essential, similar to what occurred in laparoscopic surgery.

This does not, of course, exclude the legitimate need for system-specific training. However, such programs should complement – not replace – a common foundation of robotic competencies: ergonomics, hand–eye coordination, instrument management, safety, decision-making, and anticipation of complications.

ROBOTiS, robotic surgery simulator

To meet the challenges of robotic surgery training, it is essential to rely on innovative and accessible educational tools. Traditional programs – often occasional and limited – are no longer sufficient to prepare surgical teams for the complexity of modern procedures.

In this context, the ROBOTiS simulator offers a highly realistic experience thanks to unparalleled thread modeling, faithfully reproducing its dynamics for precise skill acquisition. Portable and modular, it adapts to all levels of expertise and enhances the safety of robotic procedures.

References

(1) https://www.globenewswire.com/news-release/2025/10/30/3177278/0/en/Digital-Surgery-Technologies-Market-to-Reach-US-6-471-91-Million-by-2033-Astute-Analytica.html 

(2) https://www.academie-medecine.fr/wp-content/uploads/2025/10/Communique-Formation-chirurgie-robotique-PCRA-82.pdf 

(3) https://www.nature.com/articles/s41598-025-13323-6?utm_source=chatgpt.com

(4) https://e-memoire.academie-chirurgie.fr/en/ememoire/5788?utm_source=chatgpt.com

(5) https://www.has-sante.fr/jcms/p_3505883/fr/bonnes-pratiques-en-matiere-de-simulation-en-sante 

Follow us!

In 1985, the first robot-assisted surgical procedure was performed using the PUMA 560 system, which was used to guide a brain biopsy. In the 2000s, the introduction of the da Vinci robotic system marked a decisive turning point, enabling more precise movements, smaller incisions, and 3D visualization, ushering in a new era for robotic surgery.

In 2001, a symbolic milestone was reached in Strasbourg with the Lindbergh Operation, the first telesurgery procedure ever performed. This groundbreaking event confirmed the immense potential of robotic-assisted techniques and firmly positioned Strasbourg as a key player in this surgical revolution.

Twenty-four years later, in July 2025, the city once again hosted a landmark event in the field: the Society of Robotic Surgery (SRS) annual congress, which brought together global leaders in robotic surgery to explore the latest advances and discuss future directions for the discipline.

On this occasion, we take a closer look at 5 types of procedures in which robotic-assisted surgery has become the standard approach, examining the technological innovations, clinical benefits for patients, and the remaining challenges to overcome.

Professor Marescaux remotely controls the ZEUS robot from New York, operating on a patient in Strasbourg during the Lindbergh operation Source: https://www.ircad.fr/fr/linstitut/a-propos-de-lircad/

1. Radical Prostatectomy

Radical prostatectomy is one of the pioneering fields in robotic-assisted surgery. The robot-assisted approach has become predominant, largely due to its demonstrated benefits in surgical precision and functional recovery.

Multiple studies have reported reduced blood loss, shorter hospital stays, and improved preservation of erectile and urinary functions compared to open or laparoscopic surgery (Ho et al., 2011). These advantages have led to widespread adoption, particularly in the United States, where robotic-assisted procedures now account for the majority of radical prostatectomies performed (Ferrari et al., 2024).

CMR Surgical VERSIUS surgical robot
Sources: https://www2.cmrsurgical.com/ | https://www.ircad.fr/fr/new-partnership-with-ircad/

 

2. Partial or
Total Nephrectomy

Renal surgery, particularly partial nephrectomy, has also greatly benefited from robotic assistance.

A systematic review by Crocerossa et al. (2022) demonstrated that robot-assisted radical nephrectomy is associated with fewer perioperative complications and shorter hospital stays, without compromising oncological outcomes. Regarding partial nephrectomies, Shiroki et al. (2022) highlighted the superiority of the robotic approach over laparoscopy in terms of tumor resection precision, renal function preservation, and complication rates.

3. Colorectal
Surgery

In the colorectal field, robotic surgery is rapidly advancing, particularly for proctectomies and colectomies.

Liao et al. (2022) conducted a meta-analysis including four randomized trials, concluding that robotic procedures result in lower blood loss and reduced conversion rates to open surgery. Another study (Lin et al., 2023) suggests that integrating Enhanced Recovery After Surgery (ERAS) protocols further amplifies the benefits of robotic surgery, with positive effects on hospital stay duration and return of bowel function.

4. Hernia Repair

Robotic surgery has also found its place in hernia repair, especially for inguinal and complex incisional hernias.

A recent review (Peñafiel et al., 2024) showed that compared to laparoscopy, the robotic approach is associated with lower postoperative complication rates and improved cosmetic outcomes. For patients, this often translates into a faster return to daily activities. Iraniha & Peloquin (2018) also reported good long-term quality of life following robot-assisted inguinal hernia repair using the TAPP approach.

Hernia repair using the Da Vinci Si surgical robot from Intuitive Surgical
Source: https://www.intuitive.com/ | https://www.melbourneherniasurgery.com.au/robotic-hernia-repair.html

5. Benign Hysterectomy

Medtronic’s Hugo surgical robot
Source: https://www.medtronic.com/ | https://www.medicaldevice-network.com/news/medtronics-hugo-robot-debuts-at-guys-and-st-thomas-hospital/

Gynecologic surgery has also been profoundly transformed by robotic technology.

A meta-analysis by Lenfant et al. (2023) compared robotic hysterectomy with its laparoscopic, vaginal, and open counterparts. The study found that the robotic approach is associated with lower blood loss, shorter hospital stays, and reduced overall morbidity. However, these clinical benefits must be weighed against the higher associated costs, a factor frequently discussed in the literature.

References

Bioinformation. (2024). Patient satisfaction and quality of life outcomes following robotic-assisted surgery: A survey-based study. Bioinformation, 20(12), 1964–1969. https://doi.org/10.6026/9732063002001964

Chandhok, S., Chao, P., Koea, J., & Srinivasa, S. (2023). Robotic-assisted cholecystectomy: Current status and future application. Annals of Medicine and Surgery, 87, 104862. https://doi.org/10.1016/j.lers.2022.06.002

Crocerossa, F., Carbonara, U., Cantiello, F., Marchioni, M., Ditonno, P., Mir, M. C., Porpiglia, F., Derweesh, I., Hampton, L. J., Damiano, R., & Autorino, R. (2022). Robot-assisted radical nephrectomy: A systematic review and meta-analysis of comparative studies. European Urology Open Science, 43, 38–49. https://doi.org/10.1016/j.eururo.2020.10.034

Ferrari, D., Violante, T., Novelli, M., Starlinger, P. P., Smoot, R. L., Reisenauer, J. S., & Larson, D. W. (2024). The death of laparoscopy. Surgical Endoscopy, 38, 2677–2688. https://doi.org/10.1007/s00464-024-10774-2

Ho, C., Tsakonas, E., Tran, K., Cimon, K., Severn, M., Mierzwinski-Urban, M., Corcos, J., & Pautler, S. (2011). Robot-assisted surgery compared with open surgery and laparoscopic surgery: Clinical effectiveness and economic analyses (Technology Report No. 137). Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK168912/

Iraniha, A., & Peloquin, J. (2018). Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair. Journal of Robotic Surgery, 12, 261–269. https://doi.org/10.1007/s11701-017-0727-8

Lenfant, L., Canlorbe, G., Belghiti, J., Seshadri Kreaden, U., Hebert, A. E., Nikpayam, M., Uzan, C., & Azaïs, H. (2023). Robotic-assisted benign hysterectomy compared with laparoscopic, vaginal, and open surgery: A systematic review and meta-analysis. Archives of Gynecology and Obstetrics, 308, 1–10. https://doi.org/10.1007/s11701-023-01724-6 

Liao, G., Zhao, Z., Lin, S., Li, R., Yuan, Y., Du, S., Chen, J., & Deng, H. (2022). Robotic-assisted versus laparoscopic colorectal surgery: A meta-analysis of four randomized controlled trials. World Journal of Surgical Oncology, 20, 167. https://doi.org/10.1186/1477-7819-12-122

Lin, C. Y., Liu, Y. C., Chen, M. C., & Chiang, F. F. (2023). Learning curve and surgical outcome of robotic assisted colorectal surgery with ERAS program. Scientific Reports, 13, 12345. https://doi.org/10.1038/s41598-022-24665-w

Peñafiel, J. A. R., Valladares, G., Rodrigues, A. C. L. F., Avelino, P., Amorim, L., Teixeira, L., Brandao, G., & Rosa, F. (2024). Robotic-assisted versus laparoscopic incisional hernia repair: A systematic review and meta-analysis. Hernia, 28, 321–332. https://doi.org/10.1007/s10029-023-02881-1

Shiroki, R., Fukami, N., Fukaya, K., Kusaka, M., Natsume, T., Ichihara, T., & Toyama, H. (2022). Robotic-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy. International Journal of Urology, 29(4), 333–340. https://doi.org/10.1111/iju.13001

Follow us