Fear of innovation: public's perception of robotic surgery.

Background: Robotic surgery is used in several surgical procedures with limited evidence of clinical benefit. In some jurisdictions, the demand for robotic surgery may have been fueled by public perception of this novel technology. Therefore, we sought to investigate the public's perception of robotic surgery.

Study Design: We conducted a cross-sectional survey using a series of vignette-associated questions designed to examine the public's perception of robotic surgery. Eligible participants were recruited through Amazon Mechanical Turk's system and randomized to one of two pairs of vignettes: laparoscopic surgery compared to (1) robotic surgery, or (2) "novel surgical technology" (without using the term "robotic"). Outcomes of interest were anticipated postoperative outcomes using the surgical fear questionnaire, procedure preference, perception of error, trust, and competency of the surgeon.

Results: The survey included 362 respondents; 64.1% were male with median age of 53 years. There were no differences in the distribution of responses of the questionnaire based on use of the term "robotic" or "novel surgical technology"; therefore, the two cohorts were combined to examine perception of robotic compared to laparoscopic surgery. More respondents feared outcomes of robotic surgery than laparoscopic surgery (78.2% vs 14.9%, p < 0.001). Participants preferred laparoscopic to robotic surgery (64.4% vs 35.6%, p < 0.001).

Conclusion: The public fears recovery after robotic surgery and prefers laparoscopic surgery. The propagation of robotic surgery is unlikely based on public demand and may be more related to institutional or surgeon perceptions. Surgeons who provide robotic surgery should ensure their patients are comfortable with and understand this technology.