Public Perceptions and Determinants of Preference for Robotic-Assisted Surgery in the United Arab Emirates: Cross-Sectional Study.

Abstract

Background: Robotic-assisted surgery (RAS) is increasingly being integrated into surgical services worldwide. Successful implementation of robotic surgical technologies depends not only on clinical effectiveness but also on public trust, perceptions of safety, and willingness to use technology-enabled care. In the United Arab Emirates, the adoption of RAS is expanding rapidly; however, evidence regarding public perceptions and factors influencing acceptance remains limited.

Objective: This study aims to assess awareness, understanding, perceptions, and factors independently associated with preference for RAS among residents in the United Arab Emirates.

Methods: A community-based cross-sectional survey was conducted between July and November 2025 among adults aged 18 years or older residing across multiple emirates in the United Arab Emirates. Participants were recruited using a nonprobability convenience sampling approach through hospitals, shopping malls, community events, university mailing lists, and social media platforms. A bilingual Arabic-English questionnaire adapted from previously validated robotic surgery perception instruments was administered. Descriptive statistics summarized participant responses. Associations between participant characteristics and perceptions of RAS were examined using chi-square and Fisher exact tests. To adjust for potential confounding, a multivariable Firth-penalized logistic regression model was fitted to identify factors independently associated with preference for RAS over traditional surgeon-performed surgery. Statistical analyses were conducted using R (version 4.4.1).

Results: A total of 508 participants were included. Although 85% (n=432) had previously heard of RAS, only 38% (n=195) demonstrated an accurate functional understanding of robotic surgical systems. Overall, 33% (n=169) preferred RAS, while 35% (n=178) perceived robotic-assisted procedures as safe. The most frequently reported concerns were robotic malfunction (n=360, 71%), reduced human involvement (n=239, 47%), and procedural costs (n=183, 36%). Perceived benefits included improved surgical precision (n=331, 65%) and reduced complications (n=183, 36%). In multivariable analysis, participants who perceived RAS as safe had substantially higher odds of preferring a robot-assisted surgeon than those who were uncertain about its safety (adjusted odds ratio [aOR]=3.00, 95% CI 1.56-5.87; P<.001). Conversely, participants who perceived RAS as unsafe had substantially lower odds of preferring a robot-assisted surgeon than those who were uncertain about its safety (aOR=0.08, 95% CI 0.02-0.26; P<.001). No other factors were independently associated with surgery preference after adjustment.

Conclusions: Within this predominantly highly educated convenience sample of United Arab Emirates residents, awareness of RAS was high, but accurate understanding and acceptance remained limited. Perceived safety emerged as the factor shaping preference for RAS, highlighting the importance of trust and confidence in technology-enabled health care. These findings suggest that public education, transparent communication regarding surgeon oversight, and patient engagement strategies may be important components of the successful implementation of robotic surgical services in the United Arab Emirates.