Background: Vascular disease prevalence and mortality are increasing across Oceania, yet access to vascular and endovascular surgical care remains highly inequitable, particularly in low- and middle-income countries (LMICs). Limited data exist on service availability and barriers to care, limiting efforts to strengthen vascular services in underserved regions. Method: The Global Vascular Companionship conducted a mixed-methods cross-sectional survey of surgeons, healthcare personnel, and health ministry representatives across Pacific Island countries in Oceania, also including all sovereign nations and non-sovereign territories with populations over 100,000. Contacts were identified through professional networks and public directories. Datapoints were collected on service availability, workforce capacity, and barriers to care, and supplemented by an online search. Descriptive and thematic analyses were performed. Results: Fifteen nations were identified, with hospital numbers ranging from one to more than ten per country. Forty-nine phone numbers and 137 email addresses were contacted, yielding responses from 30 individuals. Of these, 22 completed surveys, representing 16 hospitals. Only Fiji and Guam have full-time vascular surgeons; four countries rely on visiting surgeons, while ten have no access to vascular surgeons. Thematic analysis identified system-level constraints including shortages of trained specialists, limited diagnostic imaging and endovascular equipment, inconsistent access to consumables, inadequate theatre capacity, and insufficient funding. Workforce training was most frequently identified as the intervention with greatest potential impact. Conclusion: Vascular surgical care across Oceania is profoundly inequitable, with most nations lacking sustainable local services. Targeted workforce-focused capacity building, supported by appropriate resources and regional collaboration, is urgently needed to improve equitable access to care in Pacific nations.

Purpose: To compare how artificial intelligence (AI) and robotics, both individually and in combination, are changing surgery in the short, medium and long term and to identify sub-specialties and procedures most prone to transformation. Methodology: A PRISMA guided review was performed across PubMed, Scopus, Web of Science, and Google Scholar. Bibliographies of identified articles were also reviewed. 28 studies were included for qualitative synthesis. Only studies published after 2023 were included to capture the most relevant advances in surgical AI and robotics. Results: AI was most often applied to preoperative risk prediction, imaging interpretation and intraoperative guidance. Robotics improved dexterity, visualisation and ergonomics in minimally invasive surgery, with increasing integration of image guidance into robotic systems. Procedures most susceptible to near term change were standardised, image rich and minimally invasive operations, including urology, gynaecology, bariatric, thoracic, orthopaedics and stereotactic neurosurgery. Procedures least susceptible were time critical, anatomically variable and exposure dependent operations, where adaptability and tactile judgement remains critical. Medium term changes included closer coupling of AI decision support with robotics for defined tasks and procedures. Long term changes included full integration of AI and robotics into supervised autonomous roles for selected procedures, shifting surgeons toward oversight and system governance. Conclusion: Our review suggests AI and robotics are already influencing surgical planning and intraoperative efficiency, with the largest changes seen in structured minimally invasive operations. As healthcare systems face mounting pressure from ageing populations and rising demand, the development of scalable technologies becomes inevitable. Their convergence is expected to amplify change, but clinical impact will depend on prospective validation, ethics and regulation.