Current Applications of Robotic Surgery in Aortic Procedures: A Scoping Review
Denise Filippini, Houssam Farres, Camilo Polania-Sandoval, Young ErbenObjective
To map the applications and outcomes of robotic technologies in aortic and aortoiliac procedures, including robot-assisted laparoscopic surgery, endovascular procedures, and micro-robotics.
Methods
PubMed was searched up to October 4, 2026, for primary studies including at least 3 patients treated with robotic or robot-assisted interventions for aortic or aortoiliac disease, following PRISMA-ScR guidelines. Case reports and two-patient series were summarized separately.
Results
Fifteen observational studies (552 patients) were included. Robot-assisted laparoscopic surgery (9 studies; 494 patients) was mainly applied to aortoiliac occlusive disease (385 procedures), with robotic proximal aortic anastomosis and open distal anastomoses, and less frequently to aneurysm repair. Conversion rates ranged from 0% to 20%, graft patency from 89% to 100% at up to 48 months, and hospital stay from 4 to 8 days. Robot-assisted endovascular procedures (5 studies; 49 patients) were mostly applied to single procedural steps. Robotic target vessel cannulation succeeded in 81% of vessels, and robotic gate cannulation achieved a shorter catheter path length than manual cannulation (35.7 vs 74.1 cm;
Conclusion
Robotic technologies are a promising and feasible option for selected patients undergoing aortic procedures at experienced centers. Robot-assisted laparoscopic surgery showed acceptable conversion rates and favorable mid-term patency, while endovascular robotics improved technical and surrogate endpoints. As current evidence is limited to small observational series, prospective comparative studies are needed to define the clinical benefit of robotics compared with open and endovascular repair.