title: International attitudes of early adopters to current and future robotic technologies in pediatric surgery.
abstract: BACKGROUND
  Perceptions toward surgical innovations are critical to the social processes that drive technology adoption. This study aims to capture attitudes of early adopter pediatric surgeons toward robotic technologies in order to clarify 1) specific features that are driving appeal, 2) limiting factors that are acting as diffusion barriers, and 3) future needs.
  
  
  METHODS
  Electronic surveys were distributed to pediatric surgeons with personal experience or exposure in robotic surgery. Participants were classified as experts or nonexperts for subgroup analysis. Coded Likert scale responses were analyzed using the Friedman or Mann-Whitney test.
  
  
  RESULTS
  A total of 48 responses were received (22 experts, 26 nonexperts), with 14 countries represented. The most highly rated benefits of robot assistance were wristed instruments, stereoscopic vision, and magnified view. The most highly rated limitations were capital outlay expense, instrument size, and consumables/maintenance expenses. Future technologies of greatest interest were microbots, image guidance, and flexible snake robots.
  
  
  CONCLUSIONS
  Putative benefits and limitations of robotic surgery are perceived with widely varied weightings. Insight provided by these responses will inform relevant clinical, engineering, and industry groups such that unambiguous goals and priorities may be assigned for the future. Pediatric surgeons seem most receptive toward technology that is smaller, less expensive, more intelligent and flexible.
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK; Department of Surgery and Cancer, St Mary's Hospital, Imperial College, London, UK; Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK. Electronic address: t.cundy@imperial.ac.uk.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Cundy
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK; Department of Surgery and Cancer, St Mary's Hospital, Imperial College, London, UK.
authors.forename: Hani J
authors.initials: HJ
authors.lastname: Marcus
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK; Department of Surgery and Cancer, St Mary's Hospital, Imperial College, London, UK.
authors.forename: Archie
authors.initials: A
authors.lastname: Hughes-Hallett
authors.affiliation: Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK.
authors.forename: Azad S
authors.initials: AS
authors.lastname: Najmaldin
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK.
authors.forename: Guang-Zhong
authors.initials: GZ
authors.lastname: Yang
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK; Department of Surgery and Cancer, St Mary's Hospital, Imperial College, London, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D005544:Forecasting; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D038622:Internationality; D019060:Minimally Invasive Surgical Procedures / Q000523:psychology*; D065287:Robotic Surgical Procedures / Q000523:psychology*; D018581:Technology Transfer
keywords: Children; Pediatric; Robot-assisted surgery; Robotic surgery