Year a Robot Performs Solo Surgery
Year a Robot Performs Solo Surgery
Experts give it until 2040 before a robot removes an appendix from a living patient with no human hands involved.
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Our Analysis
How do we interpret these results
Experts forecast that a robot will first successfully perform an appendectomy without physical human help around 2040. The median public participant forecasts a similar date in 2039, while superforecasters are earlier at 2035. Broadly, experts and the public give similar predictions, with little evidence of systematic difference outside the earliest tail of the distribution. By contrast, superforecasters are consistently earlier than experts, especially in the middle and upper parts of the distribution. Uncertainty remains wide: the median expert gives a 5% chance of resolution by 2030, rising to 95% only by 2060.
Forecasts by group
The year by which a typical forecaster gives the event each chance of having happened
| group | 5% | 25% | 50% | 75% | 95% |
|---|---|---|---|---|---|
| Experts | 2030 | 2034 | 2040 | 2046 | 2060 |
| Superforecasters | 2029 | 2032 | 2035 | 2040 | 2047 |
| Public | 2029 | 2033 | 2039 | 2045 | 2056 |
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* Denotes non-overlapping bootstrapped confidence intervals between group aggregates.
Rationale analysis
The main lines of reasoning driving the spread in estimates
Technical readiness—surgery vs. coffee
Many early-resolution respondents argue that surgery is a more tractable robotics problem than general-purpose tasks like the previously considered coffee test because the operating room is standardized and the procedure well-defined: "Surgery takes place in a constrained environment with controlled lighting, sterile instrumentation, known anatomy, and well understood procedural steps…From a robotics perspective that looks much more like an industrial manipulation problem than like navigating the chaos of someone's kitchen while searching drawers for coffee filters." But many late-resolution respondents argue that the structured-environment advantage is illusory once live tissue enters the picture: "An appendectomy requires manipulating wet, deformable, actively bleeding tissue that varies wildly in geometry from patient to patient. While the 2025 JHU demonstration on ex vivo pig organs was an impressive proof of concept, the gap between dead isolated tissue and a live human abdomen introduces a level of adversarial physical complexity." Another emphasizes that "the survey explicitly requires that no human steps in to tidy up, such as closing the wound. Performing perfect, adaptive suturing or knot-tying on live, elastic skin and fat layers demands an incredibly high level of haptic feedback and non-rigid body manipulation from the robot."
Jurisdiction
Another common point of divergence between forecasters concerns assumptions about where the first procedure will occur and what the accompanying regulations will be. Early-resolution respondents often argue that a less restrictive jurisdiction "likely outside the United States and Europe" will host the first success, dramatically compressing timelines: "I suspect it will happen in China (advanced AI, more risk tolerant) or a country with limited medical care after the equivalent technical capability has been proven on animals." Late-resolution respondents tend to focus more on regulatory and institutional hurdles in the West, particularly given that "the field faces a 'zero-fail' requirement": "A decade-long timeline seems at least necessary to reflect the significant regulatory and ethical hurdles," writes one. Others point to malpractice exposure, insurance frameworks, and surgeon lobbying as potential multi-decade blockers, with one writing, "I don't think any legal framework for liability exists today. That by itself will take forever." One late-resolution respondent argues that jurisdictions with weaker regulation are "unlikely to be the countries where these machines are being developed or deployed."
Economic incentive
Some late-resolution respondents emphasize that appendectomies are already safe, fast, and relatively inexpensive. One writes: "The autonomous system therefore has to be functionally perfect to justify the switch, which is a much harder bar than 'better than the alternative.'" Another adds, "It isn't clear the cost of such a system would make sense for most use cases. Appendectomy is a routine surgery that can be handled easily by many surgeons. The procedure itself is usually short and replacing the surgeon doesn't eliminate the pre and post care costs." Several early-resolution respondents, however, point to surgeon shortages and cost pressures: "Autonomous surgery has strong…support because of the high cost of surgical labor and the capacity constraints in the healthcare system." One speculates that "environments without doctors like the ISS or Antarctica" would be prime candidates for such robots.
Rationale examples
High-quality rationales from forecasters across the range
Early-resolution respondents
Existing systems like da Vinci already perform appendectomies with remote guidance. Since verbal commands are permitted, the main difference from current teleoperation is replacing the joystick with voice instructions. The remaining barriers are almost entirely regulatory, not technical. The key advantage of this approach is enabling surgery in remote locations (military, space, rural areas). ARPA-H [Advanced Research Projects Agency for Health] is already soliciting proposals for autonomous surgical robotic systems. I expect this milestone by 2030, likely first in a military or research context where regulatory approval is faster.
Capability-wise, this problem is actually easier than the Coffee Test by an extreme margin. Surgery takes place in a constrained environment with controlled lighting, sterile instrumentation, known anatomy, and well understood procedural steps. An appendectomy in particular is one of the most standardized operations in modern medicine. Laparoscopic appendectomies are already highly instrument-mediated procedures where the surgeon manipulates tools through fixed ports while viewing a camera feed…The workspace is known, the tools are known, and the task sequence is well characterized.
When this milestone is achieved, it is very likely that it will be achieved in a jurisdiction like China, which has fewer of these adoption blockers and where one can imagine a Chinese research hospital documenting an autonomous appendectomy on a consented patient under an IRB [institutional review board] protocol [and that this] would fully resolve this question.
Late-resolution respondents
Across the levels of autonomy for surgical robotics (LASR), with levels spanning from 0 (no autonomy) to 5 (full autonomy)...not a single system designated as L4 or L5 has been cleared anywhere, and my overall expectation here is that capabilities are likely to get there much faster than the (western) regulatory landscape due to adoption blockers from surgeon experts, hesitance around malpractice liability, a generally sclerotic medical device approval system, and a widespread cultural hesitance against AI being used in such high-stakes settings.
The threshold for letting a robot operate on a live human without physical intervention is shaped by much more than capability alone. It depends on whether the system can remain reliable through anatomical variation, minor complications, and the contingent texture of surgery, but it also depends on ethics review, liability, regulation, clinical trust, and the willingness of institutions to authorize a first case.
JHU [Johns Hopkins University] performed the procedure on an animal ex-vivo. In-vivo animal surgery needs to be met first before an IBR will approve it as an experimental procedure in a human. Little data exists to perform such a procedure on live animals and the in-vivo milestone will be difficult. Generalization from animal to human is uncertain which likely will make IBR approval difficult. Another IBR hurdle is that an appendectomy is mostly an emergency procedure and IBR decisions are difficult to be made in such tight timeline scenarios.
First, robotics will need to improve substantially to allow this type of highly dexterous operation to occur. Considering robotics are still struggling with 'picking' in fulfillment centers this seems to be at least 5-7 years off. Moreover, LLMs have not aided significantly in the advancement of robotic training where human demonstrations and RL techniques continue to dominate. Second, after sufficiently capable robotic hands are developed, rigorous testing and approval will be required, likely taking additional years until a human demonstration occurs.