Robot-assisted surgery has steadily expanded into plastic and reconstructive procedures, offering enhanced three-dimensional (3D) visualization, tremor elimination, and motion scaling that enable precision beyond human limitations in microsurgery, breast reconstruction, and craniofacial work.
Despite these advances, steep learning curves, high costs, and absent tactile feedback limit widespread adoption. Existing bibliometric studies either took a broad artificial intelligence (AI)-centered lens, focused narrowly on breast cancer, or relied on small datasets with mixed document types, diluting empirical insights.
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This study addresses these gaps through a rigorous, data-driven scientometric mapping based exclusively on 484 original research articles.
Study Selection and Bibliometric Methods
A systematic bibliometric search was conducted using the Scopus database, combining robotic surgery terms with plastic, reconstructive, and aesthetic surgery descriptors applied to titles and abstracts.
From 923 initial records, 919 were screened after excluding 2026-indexed entries. Restricting to English-language original research articles and removing reviews, editorials, conference papers, and other non-primary types yielded a final dataset of 484 articles published between 1996 and 2025.
No geographic, institutional, or journal restrictions were applied. Bibliographic records including authorship, affiliations, abstracts, keywords, and cited references were exported in comma-separated values (CSV) format.
Three analytical platforms were employed: Bibliometrix for descriptive statistics, citation metrics, and thematic mapping using Callon's centrality and density; VOSviewer for collaboration networks, co-citation analysis, and keyword co-occurrence mapping with association strength normalization; and CiteSpace for co-citation clustering, timeline visualization, and burst detection using g-index selection and log-likelihood ratio labeling.
Search validation was performed by two independent investigators through manual screening of random samples and cross-checking benchmark studies in robotic microsurgery and deep inferior epigastric perforator (DIEP) flap reconstruction.
Publication Trends and Research Landscape
The analysis encompassed 484 original articles from 210 sources, with an annual growth rate of 15.9% and a mean of 21.6 citations per document. Among 2077 authors, international collaborations accounted for 20.45% of publications, with a mean of 6.2 co-authors per article.
Publication output peaked at 72 articles in 2025, though this represents partial-year data. Citation impact concentrated heavily among early foundational studies, with 2001 reaching a mean of 246.5 citations per article, reflecting citation-window effects rather than superior scientific quality.
Geographically, Europe led with 38.1% of publications, followed by North America (30.4%) and Asia (27.7%). The United States dominated both productivity (27.7% of articles) and citation share (37.5%), while China demonstrated accelerated expansion after 2015. South America, Oceania, and Africa collectively accounted for under 3% of total citations.
International collaboration networks formed five clusters across 20 countries, with the strongest bilateral partnership between the United States and France. European countries exhibited dense intra-regional networks, whereas Asian contributors occupied more peripheral positions, though recent collaborative activity concentrated among China, India, and Singapore.
At the institutional level, Yonsei University and Universitätsspital Zürich led with 16 publications each, while United States institutions occupied six of the top 10 positions. Author productivity was highly skewed, with 78.8% contributing only a single publication, substantially exceeding Lotka's theoretical prediction of 60%.
Selber, J.C. emerged as the most prolific investigator with 14 publications, while Lindenblatt, N. achieved the highest field-weighted citation impact at 3.14. The author collaboration network comprised 55 researchers across 15 clusters, revealing fragmented architecture with 17 authors in isolated positions.
Bradford's Law identified 14 core journals generating 33.3% of publications. Keyword co-occurrence analysis of 430 terms revealed four thematic clusters: robotic microsurgical techniques; breast reconstruction; transoral robotic surgery; and urological procedures.
Temporal analysis showed that 85% of top keywords peaked between 2024 and 2025. Thematic evolution from 1996–2021 to 2022–2025 demonstrated diversification from microsurgery into eight derivative themes, with robotic surgery as the principal convergence point.
Thematic mapping of the papers covering 2022–2025 positioned minimally invasive surgery and transoral robotic surgery as motor themes, while robotic surgery, microsurgery, and breast reconstruction occupied basic theme status with high centrality. Force feedback and medical robots remained in emerging or declining quadrants.
CiteSpace analysis revealed six clusters with high silhouette values. Robotic microsurgery emerged as the most structurally central cluster, while AI-related nodes exhibited low centrality and no citation bursts, confirming peripheral positioning.
Key Insights and Future Directions
This first comprehensive synthesis of original robot-assisted plastic and reconstructive surgery research revealed several defining patterns. Publication output grew exponentially at 15.9% annually, with much recent expansion concentrated after 2018, yet the landscape remains geographically concentrated. North America and Europe dominate, while Africa, South America, and Southeast Asia collectively account for under 3% of citations.
Thematically, the field has evolved from foundational transoral applications toward specialized oncoplastic reconstruction and supermicrosurgery, with DIEP flap robotics an emerging theme. Collaboration networks remain fragmented despite 20.45% international co-authorship, and author engagement is strikingly episodic.
Robotic microsurgery stands as the central intellectual axis, while AI remains a nascent peripheral signal at 2.5% of the corpus. The peripheral positioning of force feedback and haptic technologies reveals a disconnect between engineering innovation and clinical implementation.
For training programs, the author suggests that these findings support curricular prioritization of supermicrosurgical competencies. Funding agencies should address geographic disparities through targeted infrastructure investment in underrepresented regions. Several limitations warrant acknowledgment, including exclusive Scopus reliance and English-language restriction.
Future research should employ comparative effectiveness methodologies and patient-reported outcomes. The evidence indicates increasing research consolidation and thematic specialization, signaling continued scholarly expansion alongside emerging computational integration.
Journal Reference
Sayegh, A., A. (2026). Research landscape of robot-assisted reconstructive and plastic surgery. Npj Digital Medicine. https://www.nature.com/articles/s41746-026-03004-7.
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