Urology and kidney
The robot is not the surgeon.
Urology is the specialty where technology is sold hardest. Some of it changes outcomes. Some of it mostly changes the invoice, and telling the two apart is most of the value of an independent opinion here.
Urology is the specialty where technology is sold hardest. Robotic assistance is a tool a surgeon uses, not a treatment in itself. For some operations, particularly prostate removal and certain kidney-sparing cancer surgery, it is associated with less blood loss and a shorter stay. For many other procedures the evidence that it improves what matters to you is much weaker, while the cost is reliably higher.
The question worth asking is never whether a hospital has a robot. It is how many times the named surgeon has performed your specific operation, and what happens if the pathology comes back worse than expected.
Medically reviewed
Reviewed by Dr Gunjan Patel, MBBS, registered with the Gujarat Medical Council (G-65059). Last reviewed 19 September 2026. Reviewed for accuracy only. This page is general information, not advice about your own case, and Dr Gunjan Patel does not diagnose, prescribe or treat.
Where an opinion helps most
Four situations where a second read changes the plan.
These are the cases where we most often find that the first recommendation was one of several reasonable options rather than the only one.
Prostate cancer, and whether to treat it now
Prostate cancer is unusual among cancers in that active surveillance, meaning careful monitoring rather than immediate treatment, is a recognised option for lower-risk disease. Surgery and radiotherapy are both established, and they carry different risks to continence and sexual function.
A surgeon offers surgery. A radiation oncologist offers radiotherapy. Neither is being dishonest, and that is exactly why a third view with nothing to sell is worth having before you choose.
Kidney cancer, and whether the whole kidney has to go
Removing only the tumour and sparing the rest of the kidney is technically harder than removing the whole organ, and it depends on the size and position of the tumour. Where it is feasible, keeping kidney tissue matters for the rest of your life, particularly if you have diabetes or high blood pressure.
It is worth establishing whether a kidney-sparing operation was considered and ruled out for a reason, or simply not offered.
Large or recurrent stones
Stone disease has several treatment routes, from shock wave therapy to keyhole surgery through the back, and the right one depends on the size, position and composition of the stone. Recurrence is common, and a plan that treats the stone without investigating why you keep forming them is half a plan.
Reconstruction after previous surgery
Urethral stricture repair and reconstruction after failed previous operations are specialised work, done well by a small number of surgeons anywhere in the world. This is the part of urology where travelling to reach a specific pair of hands can be justified.
The technology question
What to ask when a robot is part of the quote.
Not scepticism for its own sake. These are the questions that separate a genuine clinical advantage from a line item.
Worth asking, every time
- How many times has the named surgeon done this specific operation, robotically, in the last year?
- What would change for me if this were done by open or standard keyhole surgery instead?
- How much of the price difference is the robot, itemised?
- Who operates if the named surgeon is unavailable on the day, and what is their experience?
- What happens if the operation has to be converted to open surgery partway?
None of this means robotic surgery is a gimmick. In experienced hands it is a real advance for particular operations, and Indian centres perform high volumes of it.
Prostate removal is the best studied example. 1.72 days shorter hospital stay with robot-assisted radical prostatectomy than open surgery, a finding from a Cochrane systematic review of a 308-patient Australian randomised trial comparing the two approaches directly.
This day count is not stated in the original trial’s own published abstract, which reports only surgical complication rates, not blood loss or length of stay directly; it comes from a Cochrane review that extracted the underlying trial data. The same trial found fewer intraoperative adverse events with the robotic approach, 8 percent versus 2 percent, and a postoperative complication rate that trended lower but did not reach statistical significance, 9 percent versus 4 percent. Its own 24-month follow-up found no significant difference in urinary or sexual function between the two approaches at 6, 12 or 24 months, and positive surgical margins were numerically higher, not lower, with the robotic approach, 15 percent versus 10 percent, not statistically significant. The one statistically significant oncological finding, a lower biochemical recurrence rate with the robotic approach at 24 months, came with an explicit warning from the trial’s own authors against over-interpreting it, because postoperative management was not standardised between the two study arms and additional cancer treatments were used unevenly. The authors concluded that the benefit of the robotic approach is best understood as coming from its minimally invasive nature, not from a proven advantage in cancer control. This was a single-site trial with surgeons and patients not masked to which operation was performed, which limits how far the result can be generalised.
Kidney-sparing surgery to remove a tumour shows the same pattern against open surgery. 105.57 mL less blood loss with robot-assisted partial nephrectomy than open surgery, pooling 16 comparative studies of 3,024 patients with kidney tumours. 2.06 days shorter hospital stay with robot-assisted partial nephrectomy than open surgery in the same pooled analysis, which also found lower overall and major complication rates with the robotic approach.
Shen Z, Xie L, Xie W et al., World Journal of Surgical Oncology, 2016 Checked 2026-09-19.
No randomised trial has compared robotic and open partial nephrectomy, so this comes from pooling retrospective and prospective comparative studies rather than trial data, and the review that reports it calls for randomised evidence directly. Surgeons commonly reserve open surgery for larger or more anatomically complex tumours and the robotic approach for more favourable ones, which could inflate the apparent robotic advantage independent of the technology itself. This blood-loss advantage is specific to the comparison with open surgery. Against standard laparoscopic, rather than open, partial nephrectomy, two of the largest available meta-analyses (Choi et al., European Urology, 2015; Leow et al., Journal of Urology, 2016) found no statistically significant difference in blood loss.
Shen Z, Xie L, Xie W et al., World Journal of Surgical Oncology, 2016 Checked 2026-09-19.
Corroborated in direction by a larger 2025 review (Chalasani et al., Cureus) of 30 studies and almost 27,000 patients, which found a similar pattern using simple pooled averages rather than this review’s formal weighted effect sizes. As with the blood-loss figure above, no randomised trial exists for this comparison, and how surgeons select which patients receive which approach is a plausible source of bias in either direction. Against standard laparoscopic partial nephrectomy specifically, rather than open surgery, the length-of-stay advantage is smaller and less consistently reported across the two largest available meta-analyses.
What it means is that the machine is a poor proxy for the thing that predicts your outcome, which is how often that surgeon does your operation. A high volume surgeon operating without a robot is generally a better bet than a low volume surgeon with one.
We ask these questions on your behalf, and we put the answers in writing so you can compare them side by side rather than from memory.
After you fly home
Urology has a longer tail than most surgery.
This is the part that decides whether travelling was a good idea, and it is arranged before you go rather than after.
What has to be agreed in advance
- Who removes a catheter or stent, and when. This is routine, but it has to be somebody at home and it has to be booked
- Who monitors your PSA after prostate treatment, and at what intervals, for years rather than months
- Who manages continence or erectile recovery, including physiotherapy
- Who reviews kidney function if you have lost tissue
- What the escalation route is if something changes at three in the morning
Cancer follow-up in urology is measured in years. A prostate result needs watching long after the surgery is a memory, and that watching happens where you live.
So we get your own doctor into the conversation before you book anything, not after you land back with a folder. It is the second most common reason we tell somebody the plan is not ready yet.
Questions
What people ask about urological surgery abroad.
Is robotic surgery worth travelling for?
Sometimes, for particular operations, and only when the surgeon does a lot of them. The robot on its own is not a reason to fly. A surgeon with high volume in your specific procedure can be, and that is what we look for.
My PSA is raised and I have been offered surgery. Should I get another opinion?
It is one of the situations where a second opinion is most likely to be useful, because more than one reasonable path usually exists and they carry different trade-offs. That is not a criticism of the doctor who advised you. It is the nature of the decision.
Can I fly with a catheter or a stent?
Often yes, but it depends on your operation and your recovery, and it is a question for the surgical team rather than for us. What we do is make sure it is asked before anyone books a flight, and that removal is arranged at home in advance.
What if the pathology comes back worse than expected?
Then the plan changes, sometimes to include radiotherapy or drug treatment that continues for months. Ask before you travel what happens in that situation, who pays for it, and whether the follow-on treatment can be delivered at home. A plan that only describes the good outcome is not a plan.
Do you cover kidney transplant on this page?
No. Transplant has its own rules, including authorisation committee approval for foreign nationals under the Transplantation of Human Organs and Tissues Act. That is covered separately.
Get a second read before you commit to an operation.
Thirty minutes, free. If the plan you have been given is already the right one, that is what you will hear.