Singaporeans show poor understanding of robotic surgery

Singaporean patients have a poor overall appreciation of robotic surgery and harbour several misconceptions about the procedure, according to a recent study.

“Measures need to be taken to ensure adequacy of pre-operative counselling in patients undergoing robotic surgery. Misconceptions on benefits and risks of robotic surgery should be cleared before decision on the surgical access and approach,” the researchers said.

A total of 472 patients and/or their relatives were enrolled in this cross-sectional study and were made to accomplish a 19-point questionnaire about basic sociodemographic factors and their current level of understanding of robotic surgery. Overall, 55.1 percent of respondents were women, while most (55.5 percent) were aged 21–40 years.

Slightly more than half (53.0 percent; n=250) of participants reported that they had heard of robotic surgery before, of which 82.0 percent (n=205) said that they had heard so from the media. Of the overall respondent population, 18.4 percent and 60.8 percent said that they were very or somewhat interested in scientific discoveries, respectively. These participant subgroups were slightly but significantly more likely to be aware of robotic surgery (p=0.046). [J Clin Transl Res 2022;8:224-233]

Most of the participants who had heard of robotic surgery correctly attributed it as being similar to laparoscopic surgery (64.4 percent). Meanwhile, nearly half of the overall respondent pool incorrectly thought that robotic surgery was performed by an automated robot rather than by a surgeon manually controlling robotic arms (43.6 percent). Education level did not affect this perception (p=0.162).

Similarly, almost half of the respondents thought that robotic surgery was faster (46.8 percent) but more expensive (44.9 percent) than nonrobotic procedures. Only a minority of patients said that robotic surgery was safer (29.2 percent) and led to superior outcomes (29 percent).

Despite prevalent misconceptions, more than a third (33.7 percent) of the respondents said that they preferred robotic surgery. Multivariate analysis revealed that those who believed that robotic surgery led to better outcomes were more than 60 percent more likely to prefer robotic to nonrobotic procedures (odds ratio [OR], 1.61, 95 percent confidence interval [CI], 1.06–2.45; p=0.026).

In contrast, concerns that the wrong surgery may be performed with robotic means reduced the preference for robotic surgery by almost half (OR, 0.51, 95 percent CI, 0.35–0.76; p=0.001).

Operation safety, speed, cost, and associated pain were not significant predictors of preference.

“Knowledge gaps with regards to robotic surgery in general are apparent, although the extent of knowledge gap is uncertain as it is multifactorial,” the researchers said. “There is an unmet need to bridge the knowledge gap to improve patients’ understanding of robotic surgery.”

“Collaboration with healthcare workers, industry partners, and media can be made to ensure accurate portrayal of information, clarify misconceptions, and enhance patients’ understanding,” they added.