Robotic‐assisted laparoscopic surgery in urogynecology and gynecology: A global survey of current practice, perceptions, training and educational gaps

OBJECTIVE: To evaluate global access to robotic-assisted laparoscopic surgery (RAS), utilization patterns, perceptions, and training exposure among surgeons practicing in gynecology and urogynecology. METHODS: We conducted a cross-sectional, web-based international survey administered through the International Urogynecological Association (IUGA) and the European Urogynaecological Association (EUGA) between April and June 2025. Clinicians performing pelvic and reconstructive surgery worldwide were eligible to participate; participation was voluntary and anonymous. The survey assessed access to robotic platforms, procedural utilization, training exposure, perceived barriers, and attitudes toward routine implementation. Descriptive and comparative analyses were performed. RESULTS: A total of approximately 1500 clinicians were reached through professional society communication channels and 216 surgeons, fellows, and residents from 49 countries completed the survey. Overall, 148 respondents (68.5%) reported access to at least one robotic platform. The most frequently performed robotic procedure was hysterectomy (50.0%). Initial exposure to robotic surgery was most commonly industry-based (14.4%). Among surgeons with access, 58.8% considered prior laparoscopic experience essential or highly desirable. Reported barriers included high cost (19.0%), institutional limitations (10.6%), and insufficient training opportunities (9.3%). Surgeons with robotic access were more likely than those without access to consider robotics necessary for gynecology units (40.5% vs. 8.8%; P < 0.001) and to recommend its use (58.1% vs. 36.8%; P = 0.004). Higher annual case volume was associated with stronger support (49.2% vs. 22.9%; P < 0.001). CONCLUSION: Robotic-assisted surgery is widely incorporated into gynecologic and urogynecologic practice; however, access and training remain uneven. Greater exposure and higher case volume are associated with more favorable perceptions, highlighting the importance of structured educational frameworks.