{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:28:58Z","timestamp":1793892538964,"version":"4.8.0"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journalofsurgicalresearch.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Research"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jss.2026.07.041","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T09:56:23Z","timestamp":1787392583000},"page":"976-984","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Factors Influencing Robotic Surgery Adoption in the United States"],"prefix":"10.1016","volume":"326","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-2539","authenticated-orcid":false,"given":"Bryant","family":"Morocho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dev","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ponnandai","family":"Somasundar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7321-4347","authenticated-orcid":false,"given":"Steve","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jss.2026.07.041_bib1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.18911","article-title":"Trends in the adoption of robotic surgery for common surgical procedures","volume":"3","author":"Sheetz","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jss.2026.07.041_bib2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s11701-024-01914-w","article-title":"Temporal and institutional trends in robotic surgery","volume":"18","author":"Pordal","year":"2024","journal-title":"J Robot Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib3","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1001\/jamasurg.2015.5508","article-title":"Effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery","volume":"151","author":"Wright","year":"2016","journal-title":"JAMA Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib4","series-title":"Robot-assisted surgery compared with open surgery and laparoscopic surgery: clinical effectiveness and economic analyses [Internet]","author":"Ho","year":"2011"},{"key":"10.1016\/j.jss.2026.07.041_bib5","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00464-016-4954-2","article-title":"Cost analysis of robotic versus laparoscopic general surgery procedures","volume":"31","author":"Higgins","year":"2017","journal-title":"Surg Endosc"},{"key":"10.1016\/j.jss.2026.07.041_bib6","doi-asserted-by":"crossref","DOI":"10.1016\/j.amsu.2022.104803","article-title":"Embracing robotic surgery in low- and middle-income countries: potential benefits, challenges, and scope in the future","volume":"84","author":"Mehta","year":"2022","journal-title":"Ann Med Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib7","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.15052","article-title":"Trends in use of robotic surgery for privately insured patients and medicare fee-for-service beneficiaries","volume":"6","author":"Bonner","year":"2023","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jss.2026.07.041_bib8","doi-asserted-by":"crossref","first-page":"4829","DOI":"10.1007\/s00464-022-09627-7","article-title":"Socioeconomic disparities in the utilization of primary robotic hernia repair","volume":"37","author":"Tatarian","year":"2023","journal-title":"Surg Endosc"},{"key":"10.1016\/j.jss.2026.07.041_bib9","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ygyno.2015.04.031","article-title":"The centralization of robotic surgery in high-volume centers for endometrial cancer patients--a study of 6560 cases in the U.S","volume":"138","author":"Chan","year":"2015","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.jss.2026.07.041_bib10","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/21925682251356218","article-title":"Geographic and socioeconomic disparities in robotic spine surgery access in the Continental United States: a cross-sectional ecological analysis","volume":"16","author":"Mastrokostas","year":"2025","journal-title":"Glob Spine J"},{"key":"10.1016\/j.jss.2026.07.041_bib12","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1200\/JOP.200015","article-title":"Oncology care in rural Northern New England","volume":"6","author":"Johnson","year":"2010","journal-title":"J Oncol Pract"},{"key":"10.1016\/j.jss.2026.07.041_bib13","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1158\/2767-9764.CRC-23-0152","article-title":"Cancer epidemiology in the Northeastern United States (2013-2017)","volume":"3","author":"Rees","year":"2023","journal-title":"Cancer Res Commun"},{"key":"10.1016\/j.jss.2026.07.041_bib14","article-title":"Factors associated with hospital decisions to purchase robotic surgical systems","volume":"5","author":"Shen","year":"2020","journal-title":"MDM Policy Pract"},{"key":"10.1016\/j.jss.2026.07.041_bib15","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/DCR.0000000000003617","article-title":"Rise in minimally invasive surgery for colorectal cancer is associated with adoption of robotic surgery","volume":"68","author":"Manisundaram","year":"2025","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.jss.2026.07.041_bib16","series-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]","article-title":"Overview of U.S. Hospital Stays in 2016: Variation by Geographic Region","author":"Freeman","year":"2006"},{"key":"10.1016\/j.jss.2026.07.041_bib17","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1097\/DCR.0000000000000688","article-title":"Adoption of robotic technology for treating colorectal cancer","volume":"59","author":"Schootman","year":"2016","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.jss.2026.07.041_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.gassur.2026.102424","article-title":"Robotics on the rise, but not everywhere: national trends in robotic approach for colorectal cancer surgery","author":"Hu","year":"2026","journal-title":"J Gastrointest Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib19","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2022.5461","article-title":"Association of quality and technology with patient mobility for colorectal cancer surgery","volume":"158","author":"Aggarwal","year":"2023","journal-title":"JAMA Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib20","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1007\/s11912-025-01728-5","article-title":"Impact of social determinants of health on post-operative outcomes following robotic radical prostatectomy","volume":"27","author":"Najdawi","year":"2025","journal-title":"Curr Oncol Rep"},{"key":"10.1016\/j.jss.2026.07.041_bib21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11701-017-0683-3","article-title":"Socioeconomic factors and parity of access to robotic surgery in a county health system","volume":"12","author":"Tatebe","year":"2018","journal-title":"J Robot Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib22","doi-asserted-by":"crossref","DOI":"10.1093\/jncics\/pkae093","article-title":"The intersection of travel burdens and financial hardship in cancer care: a scoping review","volume":"8","author":"Planey","year":"2024","journal-title":"JNCI Cancer Spectr"},{"key":"10.1016\/j.jss.2026.07.041_bib23","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/jrh.12413","article-title":"Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the medicare population","volume":"36","author":"Longacre","year":"2020","journal-title":"J Rural Health"},{"key":"10.1016\/j.jss.2026.07.041_bib24","doi-asserted-by":"crossref","first-page":"3306","DOI":"10.1007\/s00464-022-09793-8","article-title":"Factors contributing to the utilization of robotic colorectal surgery: a systematic review and meta-analysis","volume":"37","author":"Hayden","year":"2022","journal-title":"Surg Endosc"},{"key":"10.1016\/j.jss.2026.07.041_bib25","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.juro.2012.09.033","article-title":"Disparities in access to hospitals with robotic surgery for patients with prostate cancer undergoing radical prostatectomy","volume":"189","author":"Kim","year":"2013","journal-title":"J Urol"},{"key":"10.1016\/j.jss.2026.07.041_bib26","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1001\/jama.2018.9219","article-title":"Estimation of the acquisition and operating costs for robotic surgery","volume":"320","author":"Childers","year":"2018","journal-title":"JAMA"},{"key":"10.1016\/j.jss.2026.07.041_bib27","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/j.1748-0361.2011.00371.x","article-title":"Is distance to provider a barrier to care for medicaid patients with breast, colorectal, or lung cancer?","volume":"28","author":"Scoggins","year":"2012","journal-title":"J Rural Health"},{"key":"10.1016\/j.jss.2026.07.041_bib28","article-title":"Medicaid patients have greater difficulty scheduling health care appointments compared with private insurance patients: a meta-analysis","volume":"56","author":"Hsiang","year":"2019","journal-title":"Inquiry"},{"key":"10.1016\/j.jss.2026.07.041_bib29","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1186\/s12913-025-12982-5","article-title":"Anticipated effects of centralising complex gastrointestinal surgery in a rural area in Germany - perspective of health professionals: a qualitative study","volume":"25","author":"Kugler","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.jss.2026.07.041_bib30","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/j.healthpol.2018.07.002","article-title":"Centralisation of cancer surgery and the impact on patients\u2019 travel burden","volume":"122","author":"Versteeg","year":"2018","journal-title":"Health Policy (New York)"},{"key":"10.1016\/j.jss.2026.07.041_bib31","doi-asserted-by":"crossref","first-page":"4671","DOI":"10.1200\/JCO.2008.20.1715","article-title":"Centralization of cancer surgery: implications for patient access to optimal care","volume":"27","author":"Stitzenberg","year":"2009","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.jss.2026.07.041_bib32","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/XCS.0000000000001837","article-title":"Association between surgical robotic availability and open operation rate: a geographic analysis","volume":"243","author":"Ven Fong","year":"2026","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.jss.2026.07.041_bib33","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1001\/jama.2017.7219","article-title":"Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial","volume":"318","author":"Jayne","year":"2017","journal-title":"JAMA"},{"key":"10.1016\/j.jss.2026.07.041_bib34","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1001\/jama.2015.12009","article-title":"Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial","volume":"314","author":"Stevenson","year":"2015","journal-title":"JAMA"},{"key":"10.1016\/j.jss.2026.07.041_bib35","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1056\/NEJMoa1414882","article-title":"A randomized trial of laparoscopic versus open surgery for rectal cancer","volume":"372","author":"Bonjer","year":"2015","journal-title":"New Engl J Med"},{"key":"10.1016\/j.jss.2026.07.041_bib36","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.0887-378X.2004.00325.x","article-title":"Diffusion of innovations in service organizations: systematic review and recommendations","volume":"82","author":"Greenhalgh","year":"2004","journal-title":"Milbank Q"},{"key":"10.1016\/j.jss.2026.07.041_bib37","series-title":"An Integrated Approach to Communication Theory and Research","first-page":"432","article-title":"Diffusion of innovations","author":"Rogers","year":"2014"},{"key":"10.1016\/j.jss.2026.07.041_bib38","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12913-015-0726-2","article-title":"Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic","volume":"15","author":"Zhang","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.jss.2026.07.041_bib39","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1093\/inthealth\/ihab035","article-title":"Assessing E-Health adoption readiness using diffusion of innovation theory and the role mediated by each adopter\u2019s category in a Mauritian context","volume":"14","author":"Putteeraj","year":"2021","journal-title":"Int Health"},{"key":"10.1016\/j.jss.2026.07.041_bib40","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1245\/s10434-022-12935-w","article-title":"Evaluation of the impact of the COVID-19 pandemic on reliability of cancer surveillance data in the national cancer database","volume":"30","author":"Nogueira","year":"2022","journal-title":"Ann Surg Oncol"}],"container-title":["Journal of Surgical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022480426004944?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022480426004944?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:11:38Z","timestamp":1793819498000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022480426004944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":39,"alternative-id":["S0022480426004944"],"URL":"https:\/\/doi.org\/10.1016\/j.jss.2026.07.041","relation":{},"ISSN":["0022-4804"],"issn-type":[{"value":"0022-4804","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Factors Influencing Robotic Surgery Adoption in the United States","name":"articletitle","label":"Article Title"},{"value":"Journal of Surgical Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jss.2026.07.041","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}