Research · Health robots
Robotic surgery: what the da Vinci operates on and in which hospitals
Spain has become, almost without saying so, a robotic-surgery powerhouse: 160 robots, most of them in public healthcare. This guide answers what the brochures don't: what they actually operate on, which hospitals have them, what the evidence says procedure by procedure, and what it costs when you are the one paying.
Key findings
- The robot does not operate alone: it is precision teleoperation. The surgeon decides every gesture from a console; the system filters tremor and executes it in miniature.
- Spain has about 160 da Vincis and 64% sit in public healthcare: if your hospital has one, robotic surgery costs you the same as any other, nothing.
- The prostate is the flagship use case: Spanish centers report less bleeding, 24-48 hour stays and better continence figures than open surgery.
- For simple hernias, the evidence shows no clear advantage of the robot over laparoscopy: its value appears in complex abdominal-wall reconstructions.
- Privately, robotic prostatectomy costs 20,000-22,000 euros without insurance; a laparoscopic inguinal hernia, as a reference, 2,000 to 4,500.
Few medical technologies generate as much naming confusion as this one. 'Robotic surgery' suggests a robot that operates; the reality is the opposite, and better: a surgeon who operates through a robot. The dominant system, Intuitive Surgical's da Vinci, is pure teleoperation: the surgeon sits at a console a few meters from the patient, sees the field in 3D at up to ten times magnification and moves controls; the robot removes physiological tremor, scales centimeter gestures into millimeter movements and articulates instruments that rotate where a human wrist cannot. Who decides is crystal clear, which is why this is the best-labeled robot in our catalog.
What almost nobody tells is the size of the phenomenon in Spain: about 160 installed systems, 64% of them in public healthcare. This is not luxury-clinic technology; it is general-hospital equipment, from Vall d'Hebron (the country's first with three units) to dozens of regional hospitals. This guide covers what actually matters to patients and administrators: procedures, hospitals, evidence and price.
The Spanish map: 160 robots with the public system in charge
At the close of 2024, Spanish health media counted around 160 da Vinci systems in the country, with two out of three in public hospitals: some 80 of the roughly 350 hospitals in the national health system already operate with a robot. The expansion continues: Abex, the da Vinci distributor for the peninsula, planned more than 25 new installations in 2025 alone, and regions like Madrid have bought equipment for seven more public hospitals in one sweep.
The latest generation, the da Vinci 5, landed in Spain in late 2025: Quirónsalud installed the country's first three in Madrid (Fundación Jiménez Díaz, Quirónsalud Madrid and Rey Juan Carlos) and its group now runs some twenty units. In the public system, Vall d'Hebron marked the symbolic milestone of becoming the first Spanish hospital with three robots working at once. For patients, the practical fact is simple: if your reference hospital has a robot, robotic surgery comes through the same door as any other technique, at no added cost.
The prostate, the flagship use case (and its numbers)
If robotic surgery has a flagship operation it is radical prostatectomy: removing the prostate for cancer. Anatomy explains it: the prostate lives in a narrow pelvic funnel, surrounded by the nerves governing urinary continence and sexual function, and there a robotic wrist rotating 540 degrees within centimeters earns its price. Series published by Spanish centers report far less bleeding than open surgery (with transfusions below 2%), 24-to-48-hour stays, and continence recovery within the first year for most patients.
Reading those numbers honestly requires two caveats. First, many are published by the very hospitals that bought the robot; independent comparative trials show clear advantages over open surgery (bleeding, stay, pain) and more modest differences versus advanced laparoscopy, where the decisive factor remains the surgeon's experience. Second, the oncological outcome (removing all the cancer) is equivalent between well-executed techniques: the robot improves the how, not the how much. Our standing advice applies in the operating room too: ask about the team's case volume, not just the machine.
Hernias: where the evidence urges calm
The robot also repairs hernias, and here we get to be the outlet that doesn't sell robots: for simple inguinal hernia, comparative studies show no clear advantage of robotic surgery over conventional laparoscopy in pain, recovery or recurrence, and they do show higher cost and longer operating time. Where the robot does contribute is the complex abdominal wall: large ventral hernias, component-separation reconstructions and reoperated patients, where articulated instruments allow suturing where laparoscopy struggles.
The practical translation: if you are offered robotic repair of a simple hernia privately, ask what it adds over laparoscopy in your specific case and how much it adds to the bill (laparoscopic inguinal repair runs about 2,000-4,500 euros). If your case is a complex reconstruction, the conversation changes and the robot can be justified. The y8y rule of buying for what it does today, not what it promises works the same in scrubs as in warehouses.
What it costs: public, private and insurance
In public healthcare, robotic surgery has no price for the patient: if your hospital has the robot and your case fits its indications, it is scheduled like any procedure. With 64% of the country's robots in the public system, that is now the most common access route, and the main barrier is not money but geography and each department's waiting list.
Privately, Spain's reference is robotic radical prostatectomy: between 20,000 and 22,000 euros without insurance, and around 12,000-15,000 with policies that cover the technique (not all do; that is the fine print worth reading before signing). The reason for the premium is in the da Vinci's page: systems costing $1 to $2.5 million plus single-use instruments in every procedure. It is the same economic model as the rest of healthcare robotics: an expensive machine amortized by volume, with the hospital doing the math that here the patient does.
Frequently asked
Which hospitals have the da Vinci robot in Spain?
Around 80 public hospitals plus dozens of private ones: some 160 systems in total. Among the milestones, Vall d'Hebron (Barcelona) was the first with three units, and the country's first da Vinci 5s were installed in 2025-2026 at Fundación Jiménez Díaz, Quirónsalud Madrid and Rey Juan Carlos. The reliable way to know for your case: ask your reference hospital or regional health service directly.
Does public healthcare cover robotic surgery?
Yes, where it is installed: 64% of Spain's surgical robots work in public healthcare and the procedure has no cost for the patient. Availability depends on your hospital and region; if your center has no robot, your case can be referred or resolved with laparoscopy, which offers equivalent results in many indications.
Is robotic prostatectomy better than open surgery?
Against open surgery, the advantages are well documented: far less bleeding, 24-48 hour stays and faster recovery, with equivalent oncological outcomes. Against advanced laparoscopy the differences are smaller, and the factor that weighs most on continence and sexual function is the surgical team's experience. Always ask how many your surgeon performs per year.
How much does a da Vinci operation cost privately?
The reference is robotic radical prostatectomy: between 20,000 and 22,000 euros without insurance in Spain, and around 12,000-15,000 with policies covering the technique. Not all insurers include it: check robotic-surgery coverage before signing.
Does the surgical robot ever operate on its own?
No. Across general clinical practice, the surgeon controls every movement from the console and the robot only executes: no autonomous surgery is approved. If someone sells you a robot surgeon that decides on its own, they are describing a product that does not exist.
Can surgery be performed remotely (telesurgery)?
Technically yes, and it has been demonstrated: Intuitive has performed telesurgery demos with the da Vinci 5 across more than 4,000 miles, and the technology was born precisely from that military idea. In clinical practice it remains exceptional: it requires guaranteed-latency networks, legal frameworks most countries still lack, and a full surgical team beside the patient for safety.
Numbers don’t argue. Either the robot did it alone, or it didn’t.
Sources
- La sanidad española alberga al menos 150 robots quirúrgicos
- La cirugía robótica crece en España (160 robots da Vinci, 64 % en la pública)
- La última generación del robot Da Vinci impulsa la cirugía robótica en España
- Quirónsalud incorpora en Madrid los primeros 3 robots Da Vinci de última generación de España
- Vall d'Hebron, primer centro del Estado con tres robots da Vinci
- Robot Da Vinci: precio y hospitales que lo tienen (prostatectomía privada 20.000-22.000 euros)
- La cirugía robótica Da Vinci ayuda a preservar la continencia urinaria y la función sexual tras el cáncer de próstata
- ¿Cuánto cuesta una operación de hernia inguinal en España?
- Intuitive demos 4,000-mile telesurgery with da Vinci 5 surgical robot
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