Implementation of robotics in the Operating Room

Abstract

Introduction: Robotic-assisted surgery marks a major evolution in operative practice, with ORs increasingly integrating robotic systems and digital technologies to improve precision, outcomes, and workflows. As robotics advance, the future OR is likely to in-corporate artificial intelligence (AI), machine learning (ML), and augmented reality (AR) to aid decision-making. While Health Information Technology (HIT) adoption accelerates across healthcare, realizing its benefits; it remains challenging and depends on aligning new technologies with existing processes with safety, regulatory, and labour constraints. This study reviews current implementation practices to identify best practices for inte-grating robotics into the OR.

Methods: A scoping review was conducted following the JBI Manual for Evidence Syn-thesis (2024). Searches were performed in CINAHL Complete, ProQuest Central, and Keenious using a three-step strategy: pilot search, full search with title/abstract/full-text screening, and examination of references to identify additional sources. Inclusion cen-tred on studies reporting implementation practices of robotics in the OR.

Results: Following a systematic search process, 14 studies were identified and included into this scoping review. Data were analysed inductively using content analysis. Five implementation head categories emerged, highlighting key considerations for successful robotics integration in the OR: people and teamwork, workflow and resources, training, environment and space, and outcomes with long-term adoption. Together they reveal that durable robotic integration rests on clear governance and alignment of processes, a robust, ongoing training ecosystem, thoughtful OR design, and continuous monitoring of outcomes to deliver sustained value for patients and staff.

Conclusions: The review shows that successful robotic implementation in the operating room rests on a holistic, system-wide alignment of people, tasks, technology, environ-ment, and governance with real-world workflows, not on a single factor like a surgeon’s skill or device capability. Across 14 studies, success emerges from an intricate orches-tration of interdependent levers at multiple levels—individual, team, workflow, space, and policy—that collectively shape adoption, efficiency, safety, and sustainability.