Abstract
Robotic surgery is expanding rapidly, but access remains concentrated in high-income countries and privately financed urban centres. In June 2025, our Brazilian multi-institutional consortium completed 10,000 robot-assisted procedures across five surgical specialties. These editorial reviews the development of robotic surgery in Brazil and the lessons derived from this experience. Sustainable implementation required structured training, multidisciplinary team development, appropriate case selection, standardized workflows, outcome monitoring, institutional support, and financial planning. Brazil's adoption of national training standards and the incorporation of robot-assisted radical prostatectomy into the public health system represent important steps toward broader access. The Brazilian experience shows that robotic surgery can expand in middle-income settings, but its value will depend on equitable access and local workforce development.