National adoption of robotic-assisted surgery in the United Kingdom: a decade of growth, distribution and speciality trends (2014–2024)

BACKGROUND: Robotic surgery (RS) has expanded rapidly worldwide, yet few countries have systematically documented their implementation and adoption at a national level. We aimed to provide a comprehensive overview of the UK robotic surgical landscape and detect ongoing trends. METHODS: A cross-sectional survey of all UK NHS trusts was conducted for data covering 2014-2024, capturing the presence, type and utilisations of robotic-assisted surgical systems (RASS). Trusts also reported annual procedure volumes by speciality. Data were analysed for adoption patterns, RASS and procedural growth. RESULTS: 97% (149/153) NHS trusts responded. 67% of trusts (100) used RASS in 2024 compared to 20% in 2014. By 2024, 212 RASS were operational, primarily the Da Vinci Xi (57%) with increasing uptake of alternative platforms across an increasing number of specialities. Robotic procedure volumes grew from 3 622 in 2014 to 36 209 in 2024. Urology, General Surgery, and Gynaecology accounted for 90% of procedures. With increasing use of RS, comparative analysis showed no decrease in overall volumes of minimally invasive surgery or within a single speciality. CONCLUSION: The UK has undergone significant increases in robotic capacity and experienced a tenfold increase in procedures over the past decade, with rapid diversification of platforms and specialities. We did not find that this expansion had adverse impacts on procedural volumes. These data provide a comprehensive national benchmark and highlight challenges in equality, training and health-system planning that are relevant internationally. We recommend the urgent creation of a national registry to support safe implementation and training in RS.