Knowledge, attitude, and perception of robotic-assisted surgery among the general population in Saudi Arabia: a cross-sectional study

Abstract

Minimally invasive surgery (MIS) has revolutionized surgical practices, with robotic-assisted surgery (RAS) significantly advancing. However, the understanding and acceptance of RAS vary, impacting its widespread adoption. This study aims to assess Saudi Arabians’ attitudes and comprehension of RAS, which is crucial for promoting its integration into surgical procedures. A cross-sectional study was conducted in various Saudi Arabian cities. A total of 1449 participants were included, while participants with cognitive issues were excluded. Demographic information, knowledge, technology experience, attitudes, and perceptions about RAS were collected using an online self-administered questionnaire. Data were analyzed using descriptive and inferential statistics. Of the participants, 51.1% demonstrated awareness of RAS, mainly through social media (36.9%). Factors influencing awareness included gender, education, income, occupation, computer literacy, and technology comfort. Gender disparities were evident in attitudes and perceptions toward RAS. Concerns about RAS included robot malfunction (62.0%), surgical errors (45.4%), and surgeon competency (44.7%). 36.4% of the participants believe RAS is faster, 29.9% believe RAS is less painful, and 25.3% believe RAS has fewer complications. Positive perceptions encompassed the belief that robot-using surgeons are more skilled (44.5%) and hospitals offering RAS are better (54.3%). Notably, 47.7% expressed willingness to consider RAS as a treatment option. The study underscores the significance of promoting awareness and informed decisions to ensure the successful integration of RAS in surgical practices. Addressing concerns and misconceptions and enhancing public comprehension are pivotal for facilitating informed decision-making and fostering RAS acceptance within Saudi Arabia’s surgical landscape.

Introduction

Minimally invasive surgery (MIS) has gained widespread recognition because it enhances perioperative outcomes, shortens recovery periods, and lowers complication rates compared to open surgery. Laparoscopic surgery, which put a technology interface between surgeons and their patients, was the first step in developing MIS [1]. Robotic-assisted surgery (RAS) has further advanced the potential of MIS procedures. The first robot approved for surgical use was the AESOP robot in 1994, which controlled a laparoscopic camera using voice commands. This was followed by introducing the ZEUS and Da Vinci robotic surgical systems, with the Da Vinci system being the dominant one worldwide today [2].

The Da Vinci® system, manufactured by Intuitive Surgical, has witnessed a significant increase in utilization, with over 570,000 procedures performed worldwide in 2014 [3], including 2770 (65%) in the USA, 719 (17%) in Europe, 561 (13%) in Asia, and 221 (5%) in the rest of the world [4]. However, there is a lack of awareness and expertise in robotic-assisted surgeries in certain regions, particularly in the Middle East, which has resulted in lower adoption rates. The Kingdom of Saudi Arabia purchased the first da Vinci Surgical System in the Gulf Cooperation Council (GCC) region in 2003. In total, the Middle East has 44 robotic da Vinci Surgical Systems installed, with 13 active systems and six obsolete systems (standard and S systems) in Saudi Arabia (KSA), six in Qatar, three in the United Arab Emirates (UAE), and two in each of Kuwait and Lebanon [5].

Robotic-assisted surgeries have introduced exciting advancements to surgery, including three-dimensional video monitoring, enhanced dexterity, ergonomic positioning, and the potential for remote operations. Studies have also identified that RS has the potential to shorten the learning curve as compared to straight-stick laparoscopy for trainee surgeons [6].

However, public perception is as important to the acceptability and uptake of robotic-assisted surgery (RAS) as healthcare organizations. The spread of robotic devices depends on surgeons and patients being thoroughly aware of this technology, including how it operates, which specialties employ it, the benefits it offers, and the risks it entails [3]. A survey conducted in the United States with 747 respondents revealed that 87% of participants had heard that RAS is faster and safer and results in less pain and better outcomes than conventional laparoscopic surgery. However, despite this knowledge, 55% of respondents still preferred traditional surgical approaches. Patient decision-making regarding minimally invasive surgery (MIS) is often influenced by safety, postoperative pain, and recovery time. Additionally, public acceptance of RAS is closely linked to educational levels and experience with technology, including social media. It is interesting to note that individuals who are comfortable with using computer technology tend to be more accepting of advanced healthcare technologies, including RAS [7].

Another study by Irani et al. found that many patients lacked an understanding of the differences between open, laparoscopic, and robotic-assisted surgeries. 34% did not understand the difference between open and laparoscopic surgeries, and 46% did not understand the difference between laparoscopic and robotic procedures [8]. A study by Ahn et al. focused on gynecological patients and identified gaps in patient knowledge about surgical interventions, leading to misconceptions. Research has also highlighted that the perceptions of robotic surgery among patients and medical staff do not always align with the realities of the technology [9]. For example, participants in a study by Boys et al. [3] expressed concerns about the potential malfunction of the surgical robot, believing it could cause internal damage or perform the wrong operation. There were also misconceptions about the surgeon’s role, with some participants thinking that the surgeon would watch, while the robot carried out the procedure autonomously [3]. It is worth noting that the mentioned studies had a limited scope, focusing on specific populations and countries, such as the United States. Further research is necessary to fully understand public interest and perception toward robotic-assisted surgery. This study aims to assess Saudi Arabians’ attitudes and understanding regarding RAS as a first step in promoting its use in the surgical area.

Materials and methods

Study design and setting

This is a descriptive cross-sectional study conducted in various cities across Saudi Arabia. We included the general population residing in the Kingdom of Saudi Arabia and agreed to participate in the study, while those with cognitive problems or an inability to respond to the questionnaire and those who declined participation were excluded. A pilot study involving 20 participants was conducted, but the results were not included in the final analysis. Feedback from this pilot study was attentively analyzed, leading to iterative modifications to enhance the questionnaire’s clarity, pertinence, and efficacy. After necessary revisions, the questionnaire underwent translation into Arabic. The sample size was determined using the Epi Info program formula, taking a margin of error of 5%, a confidence level of 95%, and 34,110,821 population living in Saudi Arabia in 2022 according to the records of the General Authority for Statistics, and the recommended minimum size of 385 participants was required.

Data collection and tool

Using convenience sampling, an online self-administered questionnaire was distributed via an anonymous online survey instrument adopted from the scientific literature. The first section of the questionnaire covered demographic data such as age, gender, region, nationality, education, occupation, income level, and health insurance. The second section contains questions that address the knowledge about RAS and the source of this knowledge and technology experiences such as the number of hours per week in use of computers, computer literacy, and comfort in using current computer technology. The third section addresses the attitude toward RAS, while the fourth addresses the perception toward RAS. Data collection commenced after obtaining ethical approval and continued for two months.

Analysis plan

Statistical analysis was performed using the Statistical Package for Social Science (SPSS) version 26, incorporating both descriptive and inferential statistics as per the specific research objectives. The normality of the data was tested. Frequency distributions and descriptive statistics were calculated, while the chi-square test was employed to assess associations.

Ethical approval

Ethical considerations were prioritized, and the study adhered to the guidelines outlined in Saudi Arabia. The research protocol was submitted to the Research Ethics Committee (REC) at the Jazan University for approval and assessment, Reference No.: REC-44/04/369, date of decision November 15, 2022. Informed consent was obtained from all participants, ensuring their right to withdraw from the study without any negative consequences. Measures were implemented to maintain confidentiality and preserve participants’ personal information.

Results

A total of 1449 participated in the study, with the majority, 67.8% (n = 982), being female. The largest age group represented was 18–25 years, comprising 45.2% (n = 655) of the participants, followed by the 26–35 age group with 21.0% (n = 304). Distribution across different regions of the country was fairly even, with participants from the southern (20.2%), western (19.9%), central (19.6%), northern (20.1%), and eastern (20.2%) regions (Table 1).

Table 1. Demographic and basic characteristics of the study sample

Variables	Frequency	Percent
Gender
Male	467	32.2
Female	982	67.8
Age (years)
18–25	655	45.2
26–35	304	21.0
36–45	318	21.9
46 and more	172	11.9
Region
Southern region	292	20.2
Western region	289	19.9
Central region	284	19.6
Northern region	291	20.1
Eastern region	293	20.2
Nationality
Saudi	1390	95.5
Non-Saudi	59	4.1
Level of education
Uneducated	22	1.5
Primary school	7	0.5
Intermediate school	40	2.8
Secondary school	259	17.9
University and postgraduate	1121	77.4
Occupational status
Healthcare worker	96	6.6
Non-healthcare worker	429	29.6
Students in medical field	270	18.6
Student in nonmedical field	227	15.7
Not working	427	29.5
Income level
Less than 5000 SAR	378	26.1
5000–9999 SAR	431	29.7
10,000–14999 SAR	311	21.5
Above 15,000 SAR	329	22.7
Do you have health insurance?
Yes	469	32.4
No	980	67.6
On average, how many hours a week do you use computer technology (i.e., computers, I-pods, cell phones)
0–5 h	240	16.6
6–11 h	465	32.1
12–17 h	329	22.7
18 h and more	415	28.6
How would you categorize your comfort with current technology (i.e., computers, I-pods, cell phones)?
Not comfortable	95	6.6
Somewhat comfortable	693	47.8
Comfortable	661	45.6
How would you rate your computer literacy?
Illiterate	36	2.5
Literate	963	66.5
Competent	450	31.1
Have you ever heard of robotic-assisted surgery?
Yes	740	51.1
No	709	48.9
If yes, from which resource?
Social media	535	36.9
Magazines	109	7.5
Doctors	69	4.8
Friends and relatives	27	1.9

Most participants were Saudi nationals, accounting for 95.5% (n = 1390) of the sample, and 77.4% (n = 1121) of participants had completed university or postgraduate education. Non-healthcare workers comprised the largest occupational category, with 29.6% (n = 429) of participants, followed by students in the medical field at 18.6% (n = 270).

Regarding income level, 29.7% (n = 431) of participants reported earnings between 5000–9999 SAR, while 22.7% (n = 329) reported earnings above 15,000 SAR. Regarding health insurance coverage, 32.4% (n = 469) of participants reported having health insurance.

Participants’ usage of computer technology was assessed by their average number of hours per week. Most participants, 32.1% (n = 465), reported using computer technology for 6–11 h per week. When asked about their comfort with current technology, 45.6% (n = 661) of participants reported being comfortable, while 47.8% (n = 693) reported being somewhat comfortable.

Regarding computer literacy, 66.5% (n = 963) of participants reported being literate, while 31.1% (n = 450) reported competence. Regarding awareness of RAS, 51.1% (n = 740) of participants responded affirmatively, while 48.9% (n = 709) indicated that they had not heard of it. Among those who had heard of RAS, the most common source of information was social media, with 36.9% (n = 535) of participants reporting it as their resource, followed by magazines (7.5%), doctors (4.8%), and friends and relatives (1.9%).

A comparison was conducted between individuals from the general population with and without a background in robotic surgery. The percentage of females who were aware of RAS (61.2%) significantly exceeded that of males (38.8%) (p < 0.001) (Table 2). Southern region participants (16.6%) were notably less likely to be familiar with RAS compared to individuals from other regions (p < 0.001). Participants with higher education levels (79.6%) or higher income levels above 15,000 SAR (28.0%) were more inclined to have knowledge about RAS in contrast to those with lower education levels (p < 0.001) or lower-income levels (p < 0.001). Healthcare workers (9.3%) demonstrated a higher likelihood of being aware of RAS compared to non-healthcare workers (p < 0.001). Individuals who reported using computer technology for 0–5 h per week (15.3%) were less likely to have heard of RAS compared to those who used technology for longer durations (p < 0.001). Moreover, participants who reported being somewhat comfortable (45.5%) or comfortable (49.6%) with current technology had a higher probability of being familiar with RAS compared to those who reported being not comfortable (p = 0.001). Lastly, participants who reported being literate (62.0%) or competent (36.9%) in computer literacy were more likely to have heard of RAS compared to those who reported being illiterate (p < 0.001).

Table 2. Comparison between general populations with and without a background in robotic surgery

Variables	Have you ever heard of robotic-assisted surgery				P
	Yes (740)		No (709)
	N	%	N	%
Gender
Male	287	38.8	180	25.4	0.000
Female	453	61.2	529	74.6
Age (years)
18–25	326	44.1	329	46.4	0.365
26–35	148	20.0	156	22.0
36–45	172	23.2	146	20.6
46 and more	94	12.7	78	11.0
Region
Southern region	123	16.6	169	23.8	0.000
Western region	169	22.8	120	16.9
Central region	124	16.8	160	22.6
Northern region	160	21.6	131	18.5
Eastern region	164	22.2	129	18.2
Nationality
Saudi	705	95.3	685	96.6	0.195
Non-Saudi	35	4.7	24	3.4
Level of education
Uneducated	2	0.3	20	2.8	0.000
Primary school	3	0.4	4	0.6
Intermediate school	11	1.5	29	4.1
Secondary school	135	18.2	124	17.5
University and postgraduate	589	79.6	532	75.0
Occupational status
Healthcare worker	69	9.3	27	3.8	0.000
Non-healthcare worker	233	31.5	196	27.6
Students in medical field	181	24.5	89	12.6
Student in nonmedical field	80	10.8	147	20.7
Not working	177	23.9	250	35.3
Income level
Less than 5000 SAR	165	22.3	213	30.0	0.000
5000–9999 SAR	206	27.8	225	31.7
10,000–14999 SAR	162	21.9	149	21.0
Above 15,000 SAR	207	28.0	122	17.2
Do you have health insurance?
Yes	254	34.3	215	30.3	0.104
No	486	65.7	494	69.7
On average, how many hours a week do you use computer technology (i.e., computers, I-pods, cell phones)
0–5 h	113	15.3	127	17.9	0.000
6–11 h	215	29.1	250	35.3
12–17 h	156	21.1	173	24.4
18 h and more	256	34.6	159	22.4
How would you categorize your comfort with current technology (i.e., computers, I-pods, cell phones)?
Not comfortable	36	4.9	59	8.3	0.001
Somewhat comfortable	337	45.5	356	50.2
Comfortable	367	49.6	294	41.5
How would you rate your computer literacy?
Illiterate	8	1.1	28	3.9	0.000
Literate	459	62.0	504	71.1
Competent	273	36.9	177	25.0

Another comparison was conducted between males and females to examine their attitudes toward RAS. There was no significant difference between males (46%) and females (31.3%) in understanding RAS as the surgeon sitting on a console and controlling the robot’s arm movement. However, females (29.1%) had a higher understanding compared to males (23.7%) of RAS as the robot performing the surgery while a surgeon stands by for patient safety (p = 0.001). However, males (54.7%) were more likely to choose RAS as a treatment option for a surgical condition compared to females (43.3%) (p = 0.003). Also, males (50.2%) believed that surgeons who use the robot are more skilled compared to non-robotic surgeons, while females (40.8%) held a similar belief but to a lesser extent (p = 0.037). Females (49.2%) perceived hospitals that offer RAS as better compared to hospitals that do not, whereas males (62.4%) held this belief to a greater degree (p = 0.002) (Table 3).

Table 3. General population’s attitude toward robotic-assisted surgery

Variables	Gender				P
	Male (287)		Female (453)
	N	%	N	%
What do you understand from the term robotic-assisted surgery/surgery performed using a robot?
The surgeon programs the robot, and the robot does the job	45	15.7	75	16.6	0.001
The robot does the surgery, while a surgeon stands by to ensure patient’s safety	68	23.7	132	29.1
A surgeon sitting on a console and control the robot’s arm movement	132	46	142	31.3
The surgeon instructs the surgical robot step by step	21	7.3	46	10.2
I don’t know	21	7.3	58	12.8
Would you choose robotic-assisted surgery if it was one of the treatment options for a surgical condition you may have?
Yes	157	54.7	196	43.3	0.003
No	130	45.3	257	56.7
Do you think surgeons who use the robot are more or less skilled compared to non-robotic surgeons?
More skilled compared to non-robotic surgeons	144	50.2	185	40.8	0.037
Less skilled compared to non-robotic surgeons	26	9.1	38	8.4
Similar skills to non-robotic surgeons	51	17.8	86	19
Uncertain	66	23	144	31.8
Do you think hospitals that offer robotic-assisted surgery are better or worse compared to hospitals that do not?
Better than hospitals that do not offer	179	62.4	223	49.2	0.002
Worse than hospitals that do not offer	18	6.3	33	7.3
Similar	90	31.4	197	43.5

Also, we explored the general population’s perceptions regarding (RAS). Important findings include the following: 45.5% of respondents considered RAS most similar to laparoscopic/minimally invasive surgery, while 10.9% associated it with traditional open surgery. Concerning robotic malfunction during surgery, 42.8% reported that it has occurred, and 50.0% were unsure about its incidence. Regarding choosing RAS as a treatment option, 47.7% expressed willingness to choose it. Concerns about RAS included robot malfunction (62.0%), mistakes leading to complications (45.4%), and the surgeon’s ability to handle the robot (44.7%). Perceptions of RAS compared to conventional surgery varied, with some believing it is faster (36.4%), less painful (29.9%), and has fewer complications (25.3%). In comparison, others perceived it as more painful (6.6%) or having more complications (6.5%). Respondents generally believed that surgeons who use the robot are more skilled (44.5%), and hospitals offering RAS were considered better (54.3%) compared to those that do not. These findings emphasize the need to address concerns and improve public understanding of RAS to promote informed decision-making and acceptance of this surgical approach (Table 4).

Table 4. Perceptions of general populations about robotic-assisted surgery (RAS)

Variables	Frequency	Percent
What type of surgery is robotic-assisted surgery most similar to?
Traditional open surgery	81	10.9
Laparoscopic/minimally invasive surgery	337	45.5
Laser surgery	151	20.4
I don’t know	171	23.1
Robotic malfunction during a surgery: circle the appropriate option
Has never occurred	53	7.2
Has occurred	317	42.8
Unsure	370	50.0
Would you choose robotic-assisted surgery if it was one of the treatment options for a surgical condition you may have?
Yes	353	47.7
No	387	52.3
Do you have any of the following concerns about surgery by a robot? Circle all that apply
The robot malfunctioned during the surgery	459	62
The robot performs a different operation	167	22.6
The robot makes wrong steps during the process	285	38.5
Causing mistakes that lead to internal complications	336	45.4
The surgeon does not know how to handle the robot	331	44.7
What is your perception when you hear the term “robotic-assisted surgery” as a procedure compared to conventional methods of surgery? Select all that apply
The procedure is LESS painful than open surgery	221	29.9
The procedure will have LESS complications than open surgery	187	25.3
The procedure is FASTER than open surgery	269	36.4
The procedure is MORE painful than open surgery	49	6.6
The procedure will have MORE complications than open surgery	48	6.5
The procedure is SLOWER than open surgery	51	6.9
Robot malfunction during surgery is a major concern	248	33.5
Robot mistakes causing serious complications are a major concern	170	23.0
Robot can be so accurate it will help the surgeon do a better job	296	40.0
I don’t know	134	18.1
Do you think surgeons who use the robot are more or less skilled compared to non-robotic surgeons?
More skilled compared to non-robotic surgeons	329	44.5
Less skilled compared to non-robotic surgeons	64	8.6
Similar skills to non-robotic surgeons	137	18.5
Uncertain	210	28.4
Do you think hospitals that offer robotic-assisted surgery are better or worse compared to hospitals that do not?
Better than hospitals that do not offer	402	54.3
Worse than hospitals that do not offer	51	6.9
Similar	287	38.8
Total	740	51.1

Discussion

RAS has gained significant attention in health care due to its potential benefits in precision, minimally invasive procedures, and improved patient outcomes. However, the level of awareness, knowledge, attitude, and perception toward RAS among the general population is an essential factor that can influence its adoption and acceptance. The present study aimed to examine the demographic characteristics and factors influencing the awareness of RAS among the general population in Saudi Arabia. Our findings highlight the influence of factors such as gender, region, level of education, occupational status, income level, computer technology usage, comfort with technology, and computer literacy on the awareness, perception, and attitude toward RAS in the general population.

The finding that a higher percentage of females (61.2%) were aware of RAS compared to males (38.8%) aligns with previous research indicating gender disparities in health knowledge and technology adoption. Several studies have reported that women are more proactive in seeking health-related information and are more likely to engage with digital health technologies [10, 10]. This difference could be attributed to various factors, including differences in information-seeking behaviors, socialization patterns, or varying levels of exposure to healthcare contexts.

The study highlighted a notable difference in RAS awareness among participants from the southern region (16.6%) compared to individuals from other regions. This finding is consistent with previous research that has reported regional variations in healthcare access, resources, and knowledge [10, 10]. Factors such as disparities in healthcare infrastructure, healthcare facilities capacity, limited access to information, or cultural factors could contribute to the lower awareness levels in the southern region. Future studies should investigate the regional factors influencing RAS awareness to develop targeted interventions and educational initiatives.

The study revealed a strong association between higher education levels and higher income levels above 15,000 SAR with increased RAS awareness. These findings align with previous research consistently demonstrating a positive correlation between education, income, and health knowledge [11]. Individuals with higher education and income levels often have better access to healthcare resources, including information about advanced medical technologies like RAS. Socioeconomic disparities in health knowledge can potentially impact healthcare decision-making and the equitable adoption of innovative medical procedures. Efforts should be made to bridge the knowledge gap by developing educational programs that cater to individuals with lower education and income levels.

Healthcare workers demonstrated a higher likelihood of being aware of RAS than non-healthcare workers. This observation is consistent with previous studies showing healthcare professionals as early adopters of technological medical advancements [12]. Healthcare workers are more likely to encounter and have direct exposure to RAS in their professional settings, contributing to increased awareness levels. This finding underscores the importance of targeted education and training programs for non-healthcare workers to enhance their knowledge and understanding of RAS.

The study revealed that individuals who reported using computer technology for longer durations, being comfortable with current technology, and having higher computer literacy were more likely to be familiar with RAS. These findings are consistent with existing literature on the influence of technology adoption and literacy on health-related knowledge [13]. As RAS is a technology-driven surgical approach, individuals who are more comfortable with and actively use technology will likely come across information about RAS through various digital platforms. This highlights the importance of digital health literacy initiatives and efforts to bridge the digital divide to ensure equitable access to health information.

The study found that males and females had a similar understanding of RAS as the surgeon sitting on a console and controlling the robot’s arm movement. This finding is in contrast with previous research that has demonstrated misconception in the understanding and a similar general understanding of RAS in both genders [14, 15]. However, females exhibited a significantly higher understanding (29.1%) than males (23.7%) of RAS as the robot performing the surgery while a surgeon stands by for patient safety. This difference could be attributed to variations in information-seeking behaviors, exposure to healthcare contexts, or differences in information processing related to surgical procedures.

The study revealed that males were more likely to choose RAS as a treatment option for a surgical condition compared to females. This finding is consistent with previous research indicating gender differences in treatment preferences and decision-making processes in health care [14]. It is important to note that the reasons behind these gender differences in treatment preferences were not explored in this study. Future research should investigate the underlying factors contributing to these disparities, including factors related to risk perception, information processing, and sociocultural influences.

The study found that males were more likely to believe that surgeons who use the robot are more skilled compared to non-robotic surgeons, compared to females. However, both males and females held this belief to some extent. The perception of surgeon skills may be influenced by factors such as media portrayals, technological advancements, and the perceived precision and control offered by robotic systems. Further research is needed to explore the underlying factors contributing to these gender differences in the perception of surgeon skills and the impact on treatment decision-making.

The study revealed that both males and females perceived hospitals that offer RAS as better than hospitals that do not. However, males held this belief to a greater degree compared to females. This finding is consistent with previous research demonstrating positive attitudes toward hospitals offering advanced technologies and procedures [14]. The perception of hospital quality may be influenced by factors such as perceived access to advanced medical technologies, the expertise of healthcare professionals, and the association of advanced technologies with better patient outcomes. Further investigation is needed to understand the underlying factors contributing to these gender differences in the perception of hospital quality and the potential impact on treatment decision-making.

The study revealed that a significant proportion of respondents (45.5%) considered RAS most similar to laparoscopic/minimally invasive surgery, while a smaller percentage (10.9%) associated it with traditional open surgery. These findings align with existing literature that demonstrates a general understanding among the public that RAS falls within the realm of minimally invasive surgical techniques [16]. However, it is important to note that the study did not explore the reasons behind these associations, which could be influenced by factors such as media portrayals, information sources, and personal experiences. Further research is needed to explore these factors and their impact on public perceptions of RAS.

The study found that a considerable percentage of respondents (42.8%) reported that robot malfunction occurred during surgery, while an equal percentage (50.0%) were unsure about its incidence. These findings highlight the need to address concerns and misconceptions regarding robot malfunction in RAS. While the study did not explore the reasons behind these perceptions, previous research has shown that media coverage and anecdotal reports of adverse events can influence public perceptions of technology in health care [16, 17]. Educating the public about the safety measures, rigorous testing, and monitoring protocols in place for RAS systems can help alleviate concerns and improve public understanding.

The study revealed that a significant proportion of respondents (47.7%) expressed willingness to choose RAS as a treatment option. This finding contradicts a similar study in the United Arab Emirates which suggest a negative attitude [18] suggests a positive attitude toward RAS among the general population. However, it is important to note that the study did not investigate the factors influencing this willingness, such as perceived benefits, trust in technology, or previous experiences with surgical procedures. Further research should explore these factors to understand better the motivations behind the public’s willingness to choose RAS.

The study found that perceptions of RAS compared to conventional surgery varied among respondents. Some believed that RAS is faster (36.4%), less painful (29.9%), and has fewer complications (25.3%), while a small percentage perceived it as more painful (6.6%) or having more complications (6.5%). These findings highlight the diversity of opinions regarding the benefits and drawbacks of RAS. It is important to address these perceptions through accurate and balanced information dissemination to ensure that the public understands the potential advantages and limitations of RAS compared to conventional surgery.

In line with the previous literature, respondents generally believed that surgeons who use the robot are more skilled (44.5%), and hospitals offering RAS were considered better (54.3%) compared to those that do not [3]. The literature also highlights that surgeons believe RAS enhances precision and better visualization [19]. The perception of surgeon skills and hospital quality may be influenced by factors such as media portrayals, perceived precision and control offered by robotic systems, and association of advanced technologies with better patient outcomes. Continued efforts to promote transparency, educate the public about the qualifications and training of surgeons using RAS, and provide evidence-based information about the quality of hospitals offering RAS are crucial for maintaining public trust and confidence.

The findings of this study are in line with existing literature on public perceptions of RAS. However, this study provides additional insights into the diverse perceptions of RAS among the general population in Saudi Arabia, highlighting the need for accurate information dissemination to address misconceptions and ensure informed decision-making.

It is worth noting that the present study had certain limitations. First, the study sample consisted predominantly of Saudi nationals, limiting the generalizability of the findings to other populations. Future research should include diverse populations to understand RAS awareness comprehensively. Second, the study relied on self-reported data, which may be subject to recall and social desirability biases. Future studies could employ objective measures or qualitative interviews to gain deeper insights into participants’ awareness and knowledge of RAS. Third, the study focused on the general population and did not explore specific subgroups, such as patients, healthcare professionals, or individuals with prior surgical experiences. Future research could delve into these specific populations to identify tailored strategies for enhancing RAS awareness.

Conclusion

In conclusion, this study provides valuable insights into the demographic characteristics and factors influencing the awareness of RAS among the general population. The findings highlight the impact of gender, region, education level, occupational status, income level, computer technology usage, comfort with technology, and computer literacy on RAS awareness. These findings have implications for healthcare professionals, policymakers, and public health practitioners, emphasizing the need for targeted educational campaigns, improved access to information, and enhanced digital literacy to promote awareness and understanding of advanced surgical techniques like RAS.

Author contributions

A.H.H designed the methodology; A.H.H, H.I.Al-M, and R.I.A involved in formal analysis; A.H.M and M.H.M investigated the data; H.T.A collected the resources; M.A.A, H.N.M, and I.A.H curated the data; H.N.M and A.H.H wrote the original draft; and A.A.A wrote, reviewed, and edited the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

This research did not receive any specific grant or external funding.

Data availability

Not applicable.

Declarations

Conflict of interest

There are no conflicts of interest.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

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