Since the first installation of da Vinci system in 2004, there have been 24 installations in Taiwan. Initially, this robotic system is most utilized in Urology, followed by Gynecology. Currently, it is generally accepted that the advantage of robotic surgery include embodying a steady surgical field (motion scaling), providing a magnified and three-dimensional view, and allowing surgeon’s wrist action to be reflected in the tips of the instrument, and thus the less surgeon fatigue and potentially better functional and oncologic outcomes due to more stable and precise dissection. Therefore, the application of da Vinci system is remarkably increasing in Gastrointestinal, Hepatobiliary, Thoracic, Cardiovascular, and even Otolaryngology surgeries. In National Taiwan University, more than half of robotic procedure were performed by general surgeons and colorectal surgeons, in contrast to other hospitals, in which most of the procedures were performed by urologists and gynecologists. However, there is no denying that the lack of haptic feedback, increased operative time for docking process, inability to access all four abdominal quadrants, and the need for an assistant, and most important of all, the high cost of acquisition and of maintenance of the platform are still prohibiting factors in widespread use. However, we believe that high technology is a way of no return during the civilizing process. With further refinement of robotics itself and the overcoming of the inherent challenges such as space, money, time, against tradition, and team training by the aspiring surgeons, I think we have to look toward the new technology that will carry us to a difference.
　　In the near future, robotic surgery is expected to play an increasingly important role in the surgery field. It is obvious that the cooperation between surgeons and the surgical industries will continue to innovate and improve surgical treatment modalities for patients, and therefore the surgical trainees will face more challenge than before. The minimal invasive surgery either performed by pure laparoscopic or robotic approach should achieve the goal of better operation, not to mention the smaller incisional wound and shorter hospital stay.
　　Currently, it is imperative to set up the accreditation and training system in each surgical divisions, with a view to ensuring the quality surgery and sustainable development of robotic procedures. Herein we will present such experiences from National Taiwan University Hospital.