How to Build a 24/7 Robotic Acute Care Surgery Program

Purpose of Review We examined the rationale, feasibility, and requirements for sustaining a 24/7 robotic acute care surgery (ACS) program. Our goal is to outline how continuous robotic coverage can be integrated into emergency surgical care and to identify the critical institutional and operational factors that drive its success. Recent Findings Robotic-assisted techniques are increasingly utilized in emergencies such as appendicitis, diverticulitis, incarcerated hernias, and cholecystitis, with studies reporting reduced conversion-to-open rates, shorter hospital stays, and enhanced ergonomics. Despite these advantages, most institutions limit robotic ACS to daytime hours. Around-the-clock models remain uncommon due to barriers such as staffing logistics, credentialing gaps, and OR access. However, select institutions have successfully implemented 24/7 programs through strong leadership, structured team training, performance monitoring, and financial planning. These experiences demonstrate that with coordinated strategies, barriers can be overcome, enabling broader adoption and potential improvements in patient outcomes. Summary A continuously available robotic ACS program is both feasible and potentially beneficial from clinical and operational standpoints. Its successful implementation requires a multidisciplinary, systems-based approach that integrates robust infrastructure, stakeholder engagement, ongoing training, and defined credentialing pathways. In addition to improving access to minimally invasive surgery, such programs may enhance provider well-being and standardize emergency care delivery. Future research should focus on cost-effectiveness, equitable access, and defining outcome metrics to guide broader adoption and sustainable growth.