Understanding Physicians’ Continued Use of Robotic Surgical Navigation Systems: An Integrated TAM–TPB Perspective

Robotic surgical navigation systems have become increasingly important in modern surgery, offering precision and consistency that enhance clinical outcomes. Despite their growing adoption, limited attention has been paid to the perspectives of physicians who directly operate these systems in clinical practice. To address this gap, this study investigates the determinants of physicians’ continued use of robotic surgical navigation systems by integrating the Technology Acceptance Model (TAM) and the Theory of Planned Behavior (TPB). Data were collected from 120 orthopedic surgeons across seven major medical centers in Taiwan, with 115 valid responses (96% response rate). Using Partial Least Squares Structural Equation Modeling (PLS-SEM), the results reveal that task complexity and social influence significantly affect perceived usefulness, while system self-efficacy and facilitating conditions influence perceived ease of use. Perceived ease of use indirectly impacts continuance intention through perceived usefulness, and top management support is identified as a critical reinforcing factor. These findings extend TAM and TPB to advanced surgical technologies and offer practical implications for promoting long-term adoption in clinical settings.