Robotics in Indian Urology: Evolution, Clinical Applications and Future Direction

Laparoscopy, by the 1990s, had become standard for many urological procedures, but it had intrinsic limitations: two-dimensional vision, limited instrument articulation, tremor, and surgeon fatigue, especially in deep pelvic dissections. Robotic systems were developed to overcome these barriers, offering new levels of precision and control. Robotic systems combine the minimal invasiveness of laparoscopic surgery with enhanced dexterity, three-dimensional magnified vision, tremor filtering, and ergonomic advantages that preserve surgeon precision over long operations. In this chapter, the study expands our understanding of robotics in Indian urology by tracing its evolution and technological developments, examining its clinical applications in both oncology and reconstructive surgery, exploring its advantages and limitations, reviewing training and credentialing, and outlining recent advances and future directions. Robotic technology has permeated nearly every subspecialty of urology. Although its initial appeal was confined to oncological surgery—especially prostate and kidney cancer—its role now extends to reconstructive, functional, and even pediatric urology. The combination of tele-robotics and indigenous cost-effective systems could make complex urological surgery feasible even in government hospitals serving semi-urban populations. Robotic platforms now integrate indocyanine green (ICG) fluorescence imaging, which assists in vascular mapping during partial nephrectomy, delineating renal vasculature and collecting systems. Indian surgeons increasingly use real-time fluorescence to ensure complete tumour excision while minimising ischemia.