Environmental stewardship and robotic surgery: innovation without compromise

Robotic surgery represents a major paradigm shift in surgical care, delivering significant improvements in precision, ergonomics, and postoperative patient outcomes. However, the rapid global proliferation of these systems necessitates a critical evaluation of their environmental sustainability. The healthcare sector, particularly within hospital operating theatres, is already a highly resource-intensive environment contributing substantially to national greenhouse gas emissions. The integration of robotic platforms may further exacerbate this ecological footprint through energy-intensive console and robotic arm operations, high consumption of single-use instruments, complex waste streams, and significant upstream manufacturing emissions. Recent life-cycle assessments indicate that robotic systems draw approximately 3.5 kW during operation, generating roughly 4 kg of CO₂ per hour. This is markedly higher than the 0.6 kW and 1 kg of CO₂ per hour associated with conventional laparoscopic equipment. This commentary piece aims to highlight these environmental realities for surgeons and key stakeholders. We do not advocate for the abandonment of robotic surgery, as its clinical benefits remain high. Rather, we issue a call for responsible environmental stewardship and innovation toward ecologically sustainable robotic platforms and components that maintain clinical excellence while mitigating planetary harm.