# Robotic-assisted surgery in Egypt: national insights into awareness, knowledge, and perceptions among surgeons and patients

## TL;DR

The study explores how surgeons and patients in Egypt perceive robotic-assisted surgery, finding that knowledge gaps and fears are major barriers to its adoption.

## Contribution

The study provides national insights into surgeon and patient perceptions of robotic-assisted surgery in Egypt, identifying modifiable perceptual barriers.

## Key findings

- Surgeons in Egypt have high awareness but limited knowledge of robotic-assisted surgery's local availability.
- Patients show low awareness and high fear of malfunction, which significantly reduces their preference for RAS.
- RAS-experienced patients report high satisfaction and are strong advocates for its use.

## Abstract

The integration of robotic-assisted surgery (RAS) in low- and middle-income countries (LMIC) is hindered by significant perception gaps among key stakeholders. This study evaluated the awareness, knowledge, and perceptions of RAS in Egypt to identify barriers to its adoption. A national, multi-center, cross-sectional study was conducted across ten Egyptian university hospitals (Nov 2024–Apr 2025). Validated questionnaires were administered to three cohorts: general surgical patients (n = 539), surgeons (n = 486), and RAS-experienced patients (n = 32). Multivariable logistic regression identified predictors of patient preference and surgeon support for RAS. A stark perception gap was observed. Surgeon awareness was high (90.7%), but knowledge was limited; only 56.8% knew RAS was available in Egypt. Despite this, 80.0% supported national implementation, which was independently predicted by awareness of local availability (aOR 6.35, 95% CI 3.25–12.42) and correct technical understanding (aOR 2.49, 1.48–4.18). Conversely, patient awareness was low (30.4%), with high prevalence of fears regarding malfunction (63.3%). Only 20.0% preferred RAS. Patient preference was associated with the absence of fears (aOR 0.08, 0.04–0.16) and belief in improved outcomes (aOR 4.08, 2.10–7.94). RAS-experienced patients, informed primarily by surgeons (90.6%), reported high satisfaction (84.4% “Very Good”/“Excellent”) and were strong advocates (90.6% would recommend it). RAS adoption in Egypt appears to be influenced mainly by modifiable perceptual barriers rather than demographics. Surgeons are generally supportive but under-informed, while patient hesitancy seems driven by fear that can lessen after direct exposure and education. National strategies should prioritize targeted education and the use of positive patient experiences to help address these gaps.

The online version contains supplementary material available at 10.1007/s11701-025-02942-w.