Will robots cut need for surgeons?

In January, tech billionaire Elon Musk made a prediction that ricocheted across the global technology and medical communities. Speaking on the "Moonshots" podcast, hosted by the physician and engineer Peter Diamandis, Musk said that Tesla's humanoid robot, Optimus, would surpass the world's best human surgeons within three years.

The characteristically bold claim triggered a familiar mix of excitement, skepticism, and unease. If robots could outperform elite surgeons, what would that mean for doctors, patients, and the ethics of care? And how soon would such a future arrive?

While the prediction of the Tesla CEO may sound futuristic, in hospitals across China, robots and artificial intelligence have already become part of everyday medical practice.

The reality unfolding inside operating rooms and clinics is far more cautious and more complex than Silicon Valley's most confident forecasts suggest.

Expanding frontier

In recent years, artificial intelligence and robotics have undergone explosive growth, accelerating their adoption in healthcare. Surgical robots were listed by Engineering, the journal of the Chinese Academy of Engineering, as one of the world's top 10 engineering achievements of 2024.

China has emerged as a major testing ground. By early 2025, laparoscopic surgical robots had been used in nearly 12,000 procedures nationwide, including more than 800 remote surgeries conducted via 5G-enabled robotic systems, according to a Xinhua News Agency report.

These systems allow surgeons in major cities like Beijing and Shanghai to operate on patients hundreds or even thousands of kilometers away.

At the same time, breakthroughs in large language models, like ChatGPT, have fueled the rise of what Chinese researchers call "large medical models".

According to the AI Application in Healthcare Industry White Paper 2025 published by Alibaba Cloud, by the end of 2024, China had registered 101 AI models and algorithms approved for medical services and products.

Their applications range from clinical decision support and online health consultations to drug discovery and hospital management.

Investors have taken note. Hu Guodong, deputy head of the China Center for Information Industry Development, said that while the global market for AI medical services is currently valued at about $30 billion, it is projected to reach $500 billion by 2033.

"These technologies are expected to break bottlenecks in areas like space medicine and remote care," Hu said, citing AI-powered medical services as a new engine of growth.

Yet even as the market soars, concerns are mounting about what may be lost as machines move closer to the center of medical decision-making.

In hospitals across major Chinese cities, surgical robots are no longer novelties. Many complex procedures, particularly in urology, gynecology, and gastrointestinal surgery, now involve robotic systems.

"Robot-assisted surgery offers higher precision and causes less trauma," said Zhang Kai, director of urology at United Family Healthcare in Beijing.

He said that surgical robots provide surgeons with high-definition, magnified three-dimensional views of the operative field, while robotic instruments can rotate 360 degrees — far beyond the natural range of the human wrist.

The result, Zhang said, is extreme precision. Incisions are small, typically just half a centimeter to 1 centimeter, minimizing damage to surrounding tissue and significantly reducing blood loss.

The technology traces its roots to the United States. The first surgical robot was developed in 1999 by Intuitive Surgical, the California-based company best known for its da Vinci system.

Now in its fifth generation, the system has been installed in more than 10,000 hospitals across 71 countries, according to industry figures, and has been used to treat more than 18 million patients worldwide. It entered the Chinese market in 2006, with more than 500 installations now across the country.

Despite frequent discussions about "robot surgeons" today's systems are not autonomous. They are sophisticated platforms entirely controlled by human surgeons.

"The robot does not operate on its own," said an industry insider familiar with the technology.

"The surgeon is still the decision-maker and commander," he said, adding that the robot is an extension of the surgeon's hands.

At a console, the doctor's hand movements are translated into ultra-stable mechanical actions, filtering out natural tremors and enabling delicate cutting and suturing that would be difficult to perform unaided.

Increasingly, AI is being layered onto these systems, not to replace surgeons, but to assist them. AI-based preoperative planning tools can generate high-precision reconstructions of a patient's anatomy in as little as 15 minutes, identifying lesions, critical structures, and risk zones before surgery begins.

"With more complete preoperative information and more stable execution during surgery, procedures become more controllable and predictable," one industry insider said."That's especially important for complex operations."

For patients, the benefits are tangible. Compared with traditional open surgery or conventional laparoscopy, robot-assisted procedures are associated with significantly less postoperative pain, shorter hospital stays and faster overall recovery.

"It could be as brief as one to three days," said a patient surnamed Wang, who underwent prostate surgery done with robotic assistance. "Being able to return to normal life sooner is very important to us."

His doctor said that the robot's nerve-sparing capabilities helped preserve urinary control and sexual function, outcomes that can dramatically affect quality of life.

Long-term data suggest that robotic surgery performs particularly well on functional outcomes, such as continence, while maintaining high overall safety standards.

At hospitals like Beijing United Family Hospital, da Vinci systems are now used across multiple departments, from thoracic and pediatric surgery to hepatobiliary and pancreatic procedures.

Yet even proponents of the technology emphasize a crucial caveat.

"At this stage, these surgeries still cannot happen without doctors overseeing everything," Wang's doctor said.