Abstract

''Objectives'' : To evaluate the exposure of Portuguese Urology residents (IP) to urological laparoscopy and to its training methods, comparing with the remaining Urology residents in Europe (IE). ''Materials and methods'' : A survey consisting of 23 questions concerning laparoscopic training, which was published online as well as distributed on paper, during the Annual European. Association of Urology Congress in 2012. Data was analysed with descriptive statistics, student t, Mann-Whitney and χ² tests. ''Results'' : We obtained 219 valid responses, 53 (24.2%) of which from IP. Conventional laparoscopy is equally available for both groups (78.8% of IP vs 72.0% of IE, p = NS). IP have greater access to single port laparoscopy (22.6% vs 8.4%, p < 0.05), but lesser exposure to robot-assisted laparoscopy (0% vs 21.9%, p < 0.01) in their training departments. Performance of conventional laparoscopy as first surgeons was reported by 32.7% of IP and 24.8% of IE (p = NS). The most commonly performed procedure was total nephrectomy (38.4% of IP and 28.8% of IE, p = NS). The majority in both groups considered their laparoscopic experience at the moment of the survey to be “Poor” or worse (81.9% of IP e 75.5% of IE, p = NS). However, IP had greater expectations than IE of improvement during residency (p = 0.01). No previous attendance to laparoscopic courses or fellowships was seen in 35.7% of IP and 41.7% of IE (p = NS). However, IP attended more national courses than IE. “Pelvitrainer” is the most commonly available laboratory training method, (30.2% of IP and 33.3% of IE, p = NS), but 41.9% of IP and 42.4% IE do not have access to any laparoscopic training device. Most residents (84.1% of IP and 74.4% of IE, p = NS) rate their motivation to perform laparoscopy in the future as “High” or “Very High”, and plan performing a post-residency fellowship in this field. ''Conclusions'' : The access to conventional laparoscopy is similar between IP and IE, and both take an active part in this technique. A significant proportion has some experience as laparoscopic surgeons. Despite the relative scarcity of training devices in both groups, IP attend more national courses in laparoscopy, and experience a better sense of evolution during residency than IE. © 2014 Associação Portuguesa de Urologia. Published by Elsevier España, S.L.U. All rights reserved.

Abstract

Background: Robotic surgery is an important advancement in minimally invasive surgery, providing enhanced precision, ergonomics, and visualization compared to laparoscopy. Its increasing adoption in general surgery reflects both its potential and its limitations.

Objective: To review the current role of robotic surgery in general surgery, emphasizing advances, limitations, and future perspectives.

Methods: A narrative review was performed using PubMed, Scopus, and Web of Science (2020-2023). Search terms included “robotic surgery,” “general surgery,” “da Vinci system,” and “cost-effectiveness.” Priority was given to guidelines, randomized controlled trials, systematic reviews, and meta-analyses.

Results: Robotic surgery shows advantages in ergonomics, dexterity, visualization, and conversion rates, particularly in colorectal, hernia, and hepatopancreatobiliary procedures.

Limitations include high cost, limited access, absence of haptic feedback, and the need for structured training. Emerging technologies such as novel robotic platforms, artificial intelligence, and augmented reality suggest promising directions.

Conclusions: Robotic surgery improves outcomes but requires addressing cost, access, and training challenges.