Robotic-Assisted Emergency General Surgery: Feasibility and Outcomes in Experienced Hands

Background/Objectives Robotic-assisted surgery has transformed elective general surgery, offering well-documented benefits for both surgeons and patients. However, its application in emergency settings remains underexplored. This study aims to evaluate the feasibility, safety, and effectiveness of robotic surgery in emergency general surgical cases when performed by an experienced surgical team. Methods: This observational, single-center study included 12 patients who underwent emergency robotic surgery at a high-volume tertiary care institution. All procedures were performed by the same surgeon with extensive experience in minimally invasive and robotic techniques. Demographic data and perioperative outcomes were prospectively recorded. Results: The median patient age was 73 years (range 38–91), with a median BMI of 27 kg/m² (range 25–34). The most common indications were obstructing colon tumors (66.7%) and incarcerated hernias (16.7%). The median operative time was 3 hours (range 2–6). There were no conversions to open or laparoscopic surgery. Minor postoperative complications (Clavien-Dindo Grade I–II) occurred in 2 patients (16.7%) and were managed conservatively. One intraoperative complication (ureteric injury) occurred and was identified and managed robotically without converting to open. No patient required postoperative intensive care. The median time to first flatus and oral intake was 2 days (range 1–3). The median length of hospital stay was 2 days (range 1–11), with no 90-day readmissions or mortality. Conclusions: Robotic-assisted emergency general surgery appears both feasible and safe when performed by an experienced surgical team. The absence of conversions, low complication rates, and favorable postoperative outcomes support its use in selective emergency cases without compromising patient safety or recovery.