Abstract

The da Vinci Surgical System supports surgeons across various specialties, including gynecology, urology, thoracic, cardiac, and general surgeries, as well as in cancer treatments for prostate, kidney, gynecologic, and colorectal cancers. This review article explores the ethical implications of the da Vinci system, emphasizing the integration of “Purpose Good” and “Means Good” to improve patient care. It illustrates how the system enhances surgical outcomes through precision and minimally invasive techniques, supported by significant technological advancements. The ethical suitability of robotic surgery is assessed, stressing the need for thorough treatment planning and patient selection for optimal outcomes. Additionally, the impact of robotic surgery on patient autonomy is discussed, particularly regarding informed consent and the surgeon–patient relationship. The paper emphasizes the Do No Harm Principle, highlighting the necessity for stringent training and risk assessments to mitigate patient risks. While the da Vinci system enhances precision and lowers complications, challenges like limited tactile feedback and potential robotic failures persist. The pursuit of excellence in surgical practices, guided by the Performance Excellence model, advocates for continuous improvements in surgical technology and patient care. In cancer surgery, the da Vinci system raises important ethical issues such as informed consent, accountability, and equitable access to care. The incorporation of artificial intelligence in robotic-assisted surgery requires careful consideration of patient safety, data privacy, and the implications of technology reliance on human skills. Addressing these ethical concerns is crucial for responsible implementation and safeguarding patients’ fundamental rights and safety in an evolving healthcare landscape. As robotic advancements progress, the da Vinci Surgical System represents a significant development in minimally invasive procedures, promising improved outcomes and safety in healthcare, with the potential for becoming standard practice in the future. © The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2025.