Comparison of robotic and laparoscopic surgery trials in 2025: a cross-sectional analysis of the national clinical trials registry

Background: Minimally invasive surgery (MIS) grew rapidly after the wide adoption of laparoscopic surgery, which was followed shortly by the rise of robotic surgery. While laparoscopic practice is grounded in high quality data generated by landmark clinical trials, the data driving robotic-assisted surgery is largely based on retrospective data. Thus, our aim was to compare robotic and laparoscopic trials in modern prospective MIS trial activity. Methods: This was a cross-sectional study of Phase I–IV MIS trials registered on ClinicalTrials.gov (accessed January 1, 2025). We searched the registry using the terms: “laparoscopy”, “robotic surgery” and “minimally invasive surgery”. MIS trials were grouped into laparoscopy and robotic studies. Trials were then categorized based on the interventions described (treatment, pain control, perioperative complications, technique) and by surgical subspecialty. Descriptive statistics, chi-square and Mann-Whitney U tests were used for analysis. Results: From 153 trials identified, 125 were MIS clinical trials. Laparoscopy was 2.5-fold more represented than robotic surgery in the pipeline (89 vs. 36 trials). Laparoscopic studies were more likely to be randomized (88% vs. 61%, P