Current evidence and future perspectives of robotic emergency general surgery: a narrative review

Robotic surgery is an emerging modality in acute care surgery, which encompasses emergency general surgery (EGS), trauma, and critical care. Interest in robotic approaches has increased amid rising demand for timely, efficient surgical care. This narrative review summarizes current evidence on robotic EGS, with a focus on perioperative outcomes, feasibility, and future directions. A broad review of recent systematic reviews, large-scale cohort studies, and institutional experiences was conducted to assess the use of robotic surgery in emergency general surgical procedures, including cholecystectomy, gastrointestinal emergencies, hernia repair, and appendectomy. Available retrospective evidence suggests that robotic EGS is generally feasible and is associated with perioperative outcomes comparable to those of laparoscopic surgery. Some studies have reported shorter hospital stays or lower conversion rates; however, operative times and costs tend to be higher. Safety concerns, including a potential increase in bile duct injury during acute cholecystectomy, require further evaluation. Most existing studies are retrospective and based in the United States, which limits generalizability. Robotic approaches in EGS show potential but remain insufficiently validated. High-quality prospective and randomized studies are needed to assess clinical effectiveness, cost-effectiveness, and appropriate indications across diverse healthcare settings. Broader adoption will depend on rigorous evaluation, lower costs, and effective integration into existing emergency surgical workflows.