Robotic-Assisted Surgery in Emergency General Surgery: A Prospective, Single-Center, Case Series

INTRODUCTION: Robotic-assisted surgery has transformed elective general surgery, offering well-documented benefits for both surgeons and patients. However, its application in emergency settings remains underexplored. This study aimed to evaluate the feasibility, safety, and perioperative outcomes of robotic surgery in emergency general surgical cases when performed by an experienced surgical team. METHODS: This observational, single-center study included 12 patients who underwent emergency robotic surgery at a high-volume tertiary care institution. All procedures were performed by the same surgeon with extensive experience in minimally invasive and robotic techniques. Demographic data and perioperative outcomes were prospectively recorded. Given the small sample size and single-arm design, only descriptive statistics were reported. Continuous variables are presented as mean ± standard deviation (SD) and median (range), and categorical variables as counts and percentages. No inferential statistical testing was applied, as the study was not powered for comparative analysis. RESULTS: The median patient age was 73 years (range 38-91), with a median BMI of 27 kg/m² (range 25-34). The most common indications were obstructing colon tumors (58.3%) and incarcerated hernias (16.7%). The median operative time was three hours (range, two to six hours). There were no conversions to open or laparoscopic surgery. Minor postoperative complications (Clavien-Dindo grade I-II) occurred in two patients (16.7%) and were managed conservatively. One intraoperative complication (ureteric injury) was identified and managed robotically without conversion. No patient required postoperative intensive care. The median time to first flatus and oral intake was two days (range, one to three days). The median hospital stay was two days (range, 1-11 days), with no 90-day readmissions or mortality. CONCLUSION: Robotic-assisted emergency general surgery may be a safe and feasible option in carefully selected patients when performed by an experienced surgical team with institutional support. While early results from this small cohort are favorable, further multicenter comparative studies are needed to validate these findings and define optimal patient selection.