Robotic-assisted surgery has become an integral component of minimally invasive surgery, yet its nationwide diffusion and real-world impact in France have only recently become measurable following the implementation of mandatory procedural traceability. We conducted a nationwide, retrospective, cross-sectional study. All adult patients undergoing selected urologic, digestive, gynecologic, and thoracic procedures between January 2021 and December 2022 were included. Surgical approaches were classified as robotic-assisted, laparoscopic, or open. Primary outcomes were national volumes, robotic penetration rates, and regional distribution. Secondary outcomes included length of stay, intensive care unit admission, and 30- and 90-day readmission rates. A total of 58 232 robotic-assisted procedures were identified, increasing from 27 011 in 2021 to 31,221 in 2022 (+ 15.6%), and accounting for 15.6% of minimally invasive procedures. Urology predominated (61%), followed by digestive (17%), gynecologic (15%), and thoracic surgery (7%). Robotic penetration reached 54.9% in urology but remained below 15% in other specialties. Marked regional disparities were observed, with Île-de-France accounting for over 27% of all robotic procedures, while several regions reported minimal or no activity. Compared with laparoscopic and open surgery, robotic-assisted procedures were associated with shorter length of stay (4.2 vs. 5.7 and 7.9 days, respectively), lower intensive care unit admission rates (6.3% vs. 9.7% and 14.1%), and reduced 30-day readmissions (4.8% vs. 5.6% and 6.9%). Robotic-assisted surgery in France is expanding and associated with improved early postoperative outcomes, but its adoption remains highly uneven, highlighting the need for coordinated national planning.
Saiydoun et al. (Mon,) studied this question.