A Bibliometric Analysis on Application of Robot-Assisted Surgery in Plastic Surgery

Strategy for Data Collection and Screening Criteria

As one of the most widely recognized and regularly maintained online multi-disciplinary scientific literature database around the world, the Web of Science Core Collection (WoSCC) contains a relatively larger time-span of indexed articles with a lover possibility of incorrectness compared other available online database as well as its feature called the “Keywords Plus” that is exclusively provided by the WoCSS among all online databases available currently and subsequently enables more accurate result within the keywords analysis. Therefore, the WoSCC was identified as the only data source for this bibliometric analysis. It was systemically retrieved on July 1, 2025. The “robot”, “robot surgery”, “robotic surgery” and “robot-assisted surgery” were chosen as the synonyms for the robot-assisted surgery. The “plastic surgery”, “cosmetic surgery”, “aesthetic surgery”, “lymphoedema”, “microvascular”, “flap”, “abdominal wall”, “pelvic floor”, “craniofacial”, “maxillofacial”, “mandible”, “mandibular”, “breast”, “mammoplasty”, “mammaplasty”, “nose”, “nasal”, “rhinoplasty”, “auricle”, “auricular”, “otoplasty” and “genital” were identified as the synonyms for the plastic surgery. All synonyms keywords were examined and simultaneously agreed by all authors of this article to guarantee the sensitivity and comprehensiveness of enrolled studies. The synonyms of plastic surgery and robot-assisted surgery were taken intersection for literature searching. The searching was limited with in the “title” (TI) to ensure enough specificity of the searching.

Considering the characteristics of the bibliometric analysis to directly and reflect the real trend of development in a certain subject from a specific period of time, no additional subjective criteria that may vary from different authors during the data screening was not utilized. Here in this study, the publication time was set from 2000 to 2025 to ensure the reliability and credibility given the swiftly developing and iterating robotic and computational technology. The genre of enrolled studies are limited within the “article”, “review article”, “editorial material” and “early access” to ensure the information completeness of all literature for subsequent analysis. As for the exclusion criteria, the literature in the format of “proceeding paper”, “meeting abstract”, “letter”, “correction”, “book review”, “retracted article” and “news item” was excluded from this bibliometric analysis. The literature published before year of 2000 and not written in English was also excluded. All the records of literature that meet the screening criteria approved also by authors were digitally downloaded on the same day of searching in plain text format with “Full Record and Cited References” from WoSCC for subsequent analysis.

Data Analysis and Visualization

The bibliometrix package (version 5.0.1) ¹⁴ which is operated on the platform R software (version 4.4.3) with a graphical interaction interface was utilized for data analysis and visualization. The author’s keywords were identified as the factors for the generation of thematic map and trend topics plot. The “Keywords Plus” function was utilized for keywords analysis which is provided by the WoSCC.

Overview of Enrolled Literature

Totally 208 publications from 116 different sources were identified based on the WoSCC from the year of 2000 to year of 2025. As for the participation of the academic community, 1001 authors are involved in the study concerning of application of the robot-assisted surgery technology in the plastic surgery. Might be related to the perplexity of the embodied surgical robot and the high demand for the equipment to the utilized on patients, only 4 literature is single-authored while other 204 articles are finished by the collaboration among which the international ones takes a considerable proportion. From the overall trend, this is an indeed a prospering topic because the annual scientific output is developing steadily and gradually increasing with an annual growth rate of 12.95% (Figure 1). A sufficient number of researchers ensures their sustainable development in the future and is large enough to produce innovative results and invested in clinical use. Most of the literature is updated with 4.63 in the average age of the literature, which guarantees the integrity and credibility of scientific information.

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Figure 1.

The Number of Published Articles Concerning the Application of Robot-Assisted Surgery in Plastic Surgery in Every Year.

Analysis on Authors

As the compelling reason for the subjective development, the authors that have a close relationship with the topic should be attached great importance for investigation. In this study, the relevance of the authors are measured by the number of published literature. The first twenty-five authors ranked by the number of their published articles are respectively, Chai G (N = 10); Lin L (N = 9); Kim H, Lee J and Zhang YD (N = 7); Du HY, Kim D, Kim HJ, Koh YW, Park HS, Sun MZ, Xie L, Xu HS and Zhang Y (N = 5), Beeraka NM, Cha IH, Chen K, Cho SU, Duan XG, He YC, Kim BS, May M, NAM W, Shi YY And Zhang J (N = 4). (Figure 2(A))

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Figure 2.

(A) The Top Relevant Authors and the Corresponding Number of Their Publications. (B) The Number of Publications of Each Aforementioned Authors in Each Year. (C) The Collaboration Network of Researchers in the Field About Robotic Plastic Surgery.

If the number of publication of the authors mentioned is correlated against the year, it can be easily seen that a great proportion of scientific achievements of most of these authors are published after the year of 2015. And most of these authors has a long history of academic dedication. Interestingly, in the year from 2021 until the year of 2024, most authors all have a relatively higher number of published scientific achievements, which might be associated with a long-term knowledge gathering and the development of fundamental techniques such as computer technology (Figure 2(B)).

The collaboration network analysis shows that the academic collaboration is widely exists and researchers in this field can be roughly divided into nine clusters. Within which the red cluster brown cluster are relatively tightly interconnected as most of authors in these clusters are the most relevant and productive authors listed above. It shows that the scientific cooperation in the field is relatively common and widespread, which is also a positive signal for the benign and sustainable development of this field (Figure 2(C)).

Analysis of Sources

The source of the literature which can be also roughly regarded as the journal of the published articles is not undoubtedly a negligible factor during the bibliometric analysis. The top twenty relevant sources which is scales by the number of publications are shown previously. It can be clearly observed that most of journals only occupies a number of three articles with a relatively smaller portion of sources have a higher degree of academic influence including the International Journal of Medical Robotics and Computer Assisted Surgery (N = 7), Journal of Craniofacial Surgery (N = 7), Plastic and Reconstructive Surgery (N = 7), IEEE Access (N = 6), Journal of Robotic Surgery (N = 6), IEEE Robotics and Automation Letters (N = 5), Journal of Clinical Medicine (N = 5) and Annals of Surgical Oncology (N = 4). (Figure 3(A))

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Figure 3.

(A) The Top Relevant Sources and the Number of Their Publications. (B) The Number of Publications of Each Sources Mentioned Above in Each Year.

Similarly, when it comes to putting the number of publications of each aforementioned journals against the year, it can be easily spotted that most of these relatively centered journals in this field encountered the surge after the year of 2012-2013, which is also roughly correlate the time during which the publications soared analyzing from the aspect of authors. (Figure 3(B))

Analysis of Affiliation

The institution where the research was conducted is not only a physical basis for the prosperity in the academic achievement but also the platform for the researchers mentioned above. It should not be easily neglected during the bibliometric analysis. In the field, the Shanghai Jiao Tong University takes the predominance with 35 publication with the Yonsei University and Yonsei University Health System take the second rank by 24 publications. The University of Tokyo (N = 14), Chang Gung Memorial Hospital (N = 12), Harbin University of Science and Technology (N = 11) along with Beijing Institute of Technology (N = 10) jointly occupy the second cluster from the aspect of productivity. In addition, the Asan Medical Center, Peking University and University Of Ulsan holds the third ranking group with the same number of publication of nine (Figure 4(A)).

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Figure 4.

(A) The Top Relevant Affiliations and the Number of Their Publications. (B) The Number of Publications of Each Affiliations Mentioned Previously in Each Year.

Meanwhile, from the aspect of correlation between the number of academical achievement and the trail of timeline. Nearly all of the aforementioned institutions meet with the sharply increase with different speed in the production in the period around the year of 2015, which is also precisely match with the surge judging from the authors and journals (Figure 4(B)).

Trend Topics Analysis

Understanding the direction and hotspots of scientific research progress in a topic can also be gained by examining the evolution of words emergence and disappearance, or the period at which a certain term emerges and vanishes. The trend of topics is measured from the aspect of the authors’ keywords. And it can be seen that the research hotspots on the exploration of robotic technology on the topic of plastic surgery varied from “needle insertion”, “Da Vinci” and “augmented reality” in years before to the “breast reconstruction”, “flap”, “lymphocele” in recent years. This shift indicates that the utilization of robotic technology in the plastic surgery generally focusing broadly on the aesthetic improvement and life-quality enhancement rather than the traditional cutaneous cancerous treatment (Figure 5(A)).

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Figure 5.

(A) The Trend Topics Analysis in the Scope of all Enrolled Studies. (B) The Co-Citation Network of All Studies Included in This Bibliometric Analysis.

Co-Citation Analysis

A co-citation relationship existed when two studies were referenced jointly by a third study. The co-citation analysis is capable of showing the intrinsic even the evolution of the subject from the perspective the reference. In this time of analysis, all of the enrolled literature can be roughly divided into roughly six sub-groups, and within which the yellow, brown and green cluster are closely connected. For researchers firstly get in touch with topic about the application of robotic-assisted surgery especially in the direction of plastic surgery, reading the literature in the center of each groups would be a beneficial choice for a swift comprehension and proficiency (Figure 5(B)).

Keywords Analysis

As a window to partially observe the trend in the change in the direction of the research, the frequency of words appeared in the literature is also included in the analysis. In this time, the keywords plus feature provided by the Web of Science is utilized in this analysis. The “system” have the largest number of appearance with a number of 25 of mentioning. The words “surgery” (N = 22), “cancer” (N = 21), “outcomes” (N = 17), “feasibility” (N = 14), “head” (N = 13), “complications” (N = 11) can be roughly allocated in the second rank. The “management” and “nipple-sparing mastectomy” both have nine times of appearance. Lastly, the “quality-of-life” and “experience” both have eight times of mentioning. All these words can be roughly regarded as the hot directions in the first quarter of this century (Figure 6(A)).

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Figure 6.

(A) The Top Relevant Terms Counted by the “Keywords Plus” Feature and the Number of Occurrence in the Field of Robot-Assisted Plastic Surgery. (B) The Thematic Map Generated on the Literature of the Robot-Assisted Surgery in Plastic Surgery.

Thematic Map of Publications

The thematic map measured by the author’s keywords shows the develop stage of a certain sub-topics in this field. This map is divided into four parts by the centrality line (y-axis) and density line (x-axis). Generally speaking, the concept of “lymphocele”, “transoral robotic surgery”, “biofeedback”, “breast cancer”, and “meta-analysis” are within the motor quadrant which means that they are in relatively central position and well developed. And they can be regarded as the current hotspots in academia and represents the potential developmental direction in this field. In comparison, the basic quadrant contains titles with similar high centrality but not highly developed as well, such as “open surgery” and “Da Vinci surgical system”, which are generally regarded as the foundation for the further development of robot-assisted surgery. Thirdly, the terms in the niche quadrant means that they are well developed but with low centrality, which contains “boari flap” and “neck dissection” that in need of more focusing and investigation. Last but not the least, the topics in the emerging and declining quadrant means that they are poorly developed and poorly centrally positioned, which are “tumor manipulation”, “pelvic organ prolapse” and “sacrocolpopecy” and they quite in urgent need of attention (Figure 6(B)).