# Health technology assessment of surgical robots: a mini-review of a rapidly evolving field

## TL;DR

This paper reviews how surgical robots challenge traditional health assessments due to their high cost and rapid development, suggesting new evaluation methods are needed.

## Contribution

The paper introduces the need for dynamic, holistic HTA frameworks tailored for surgical robots and AI-integrated systems.

## Key findings

- Traditional HTA methods are inadequate for surgical robots due to their complexity and rapid iteration.
- There is a lack of standardized frameworks and long-term data for assessing surgical robots.
- Future HTA should adopt dynamic, patient-centered models integrating AI and global value dimensions.

## Abstract

Surgical robots enhance precision and enable minimally invasive procedures but pose challenges for traditional Health Technology Assessment (HTA) due to high costs, organizational disruption, and rapid iteration.

This review first reviews the development trajectory of surgical robots and their applications in modern surgery. It then elaborates on the fundamental definition and value dimensions of HTA, highlighting the IDEAL framework specifically designed for evaluating complex surgical innovations and its tailored recommendations for surgical robots. Then provides a detailed analysis of specific challenges encountered in HTA of surgical robots.

This review thoroughly examines two core controversies in current assessment paradigms: the debate over the roles of randomized controlled trials (RCTs) vs. real-world evidence (RWE) in the evidence hierarchy, and the paradigm tension between traditional cost-effectiveness analysis and the broader Value-Based Healthcare (VBHC) approach. Key identified research gaps include: the lack of standardized HTA frameworks accounting for medical device characteristics, insufficient long-term patient-centered outcomes and system-level impact data. Looking ahead, the assessment of surgical robots is evolving toward dynamic, iterative “living” HTA models, urgently requiring new paradigms to evaluate AI-integrated intelligent systems and ultimately striving toward a comprehensive assessment system integrating broad value dimensions with a global perspective.

Static HTA methods, primarily designed for pharmaceuticals, are inadequate for complex, rapidly evolving platforms like surgical robots. Establishing a more dynamic, holistic, and standardized assessment paradigm is crucial to ensure safe, effective, and cost-efficient benefit for patients and society.