Robot-assisted surgery provides the next step in surgical evolution. Where laparoscopic surgery shortened both hospital stay and recovery, it often prolonged the surgical procedure. Novel laparoscopic instruments such as robotic systems improve visibility and patient outcome. Recent randomized studies show improved functional patient outcome after robot-assisted laparoscopic prostatectomy. Introduction of image-guided surgical technologies is aided by robotic systems. Outside medicine, randomized controlled studies in technological improvements are non-existent. A careful monitoring of study results is mandatory for the introduction of novel technologies in the field of medicine.