A Systematic Review of Current Practices, Challenges, and Future Directions for the Use of Robotic Surgery in Otolaryngology in Greece.

Robotic surgery is increasingly used in otolaryngology (ENT), particularly for complex head and neck procedures. It offers various advantages, including limited postoperative pain, excellent aesthetic results, better visualization in the surgical field, enhanced dexterity due to movement adjustment by the robotic system, and minimal complications and hospital stay. However, robotic systems' higher cost and limited availability are a burden for clinical applications. This systematic review is a detailed assessment that looks at the existing situation, problems, and prospects for robotic ENT surgery in Greece. It is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The included studies were chosen based on specific criteria after a thorough inspection of electronic databases of clinical trials and medical journals (PubMed, Scopus, Web of Science). Despite steady adoption, Greece needs to catch up with other European countries in deploying robotic surgery technology. Various possible reasons may cause the small number of ENT robotic-assisted surgeries, including the high cost and the availability of robotic systems, mainly in large private or public hospitals in the main cities of Greece (Athens and Thessaloniki). Training on robotic systems is also very limited for surgery residents and young surgeons, while the learning curve of robotic-assisted surgeries in ENT is big. Peer-reviewed literature was analyzed to compare it with other European nations and investigate the economic, training, and geographic aspects that may be a burden for the rise of robotic surgery in Greece. Through the review scope, this study also provided recommendations concerning the implementation of robotic surgery in daily practice among surgeons in Greece and the difficulties that may arise regarding robotic surgery training in resource-limited countries.