Robotic Surgery Use After Emergency Transfer Varies Across Hospitals

Karikis I, Arda Y, Pachos N, et al. Robotic Operation After Interhospital Transfer for Emergency General Surgery: Adoption, Hospital-Level Variation, and National Outcomes. J Am Coll Surg. September 2026.

Robotic surgery is increasingly used in emergency general surgery (EGS), but its adoption and outcomes after interhospital transfer remain unclear. Karikis et al. examined robotic surgery adoption, hospital variation, and outcomes among adults transferred for EGS, using the 2016–2019 Nationwide Readmissions Database.

Adjusted models compared robotic, laparoscopic, and open procedures for costs, hospital stay, discharge destination, complications, mortality, and 30-day readmission.

Robotic procedures occurred in 8.5% of hospital-years receiving transfers and 13.7% of those with robotic capability. Variation between hospitals was greater for robotic versus laparoscopic selection than for robotic versus open selection. Investor ownership and later study years predicted greater robotic use; extreme illness severity and rural residence predicted less use.

Relative to laparoscopy, robotic surgery was associated with shorter stays but greater costs, with no significant adjusted clinical outcome differences. Relative to open surgery, it was associated with shorter stays, lower costs, and reduced odds of surgical complications and discharge somewhere other than home.

The authors concluded that uncommon, variable adoption warrants clearer patient selection criteria and evaluation of equitable access to minimally invasive surgery.