The primary aim of this report was to assess the efficacy and safety of robot-assisted surgery, compared to laparoscopic and open surgery for partial nephrectomy, adrenalectomy, radical prostatectomy, radical cystectomy, hysterectomy and ovariectomy. Furthermore, the costs (for acquisition, maintenance, etc.) of robotic surgery from the perspective of hospitals were calculated and the future of robotic surgery was evaluated.

In addition to a literature search, the respective manufacturers were contacted. Furthermore, for evaluating the future of robotic surgery, a survey was sent to Austrian experts. None of the 26 identified studies have shown a significant patient-relevant benefit of robot-assisted surgery – at least not for nephrectomy, adrenalectomy, prostatectomy, cystectomy or hysterectomy. There are probably some benefits of robotic-assisted surgery for outcomes such as length of hospital stay or potency after prostatectomy.

On average the acquisition costs of a da Vinci® surgical system are around 1.5 million Euros, with those for maintenance amounting to approx. 150,000 Euros per year and nearly 1600 Euros operational cost per surgery. The amortisation of a da Vinci® surgical system is only possible when a high number of cases is guaranteed and a high amount from the generated lump sums is provided to amortise the costs.

Overall, the experts prognosticated that robotic surgery in Austria will further grow, at least in certain fields. Due to an increasing competition pressure, the costs for robotic surgery could decrease in the future.