Purpose: As robot-assisted surgery is disseminated worldwide, it is necessary to consider both technical and non-technical aspects of its implementation. Numerous ethical challenges have been ascribed to practising robot-assisted surgery. To truly deliver patient-centred care, patient perspectives should guide frameworks to support ethical implementation. Methodology: A literature review of ethical considerations and patient perspectives on robot-assisted surgery was conducted. We applied bioethical principles to develop an empirical framework to guide the ethical implementation of robot-assisted surgery. Results: For implementing robot-assisted surgery, the key ethical issues described are evidence, biases, informed consent, conflicts of interest, advertising, and access. Most patient-reported literature focused on patients' cognitive and emotional biases with heterogeneous patient perceptions. There is a mismatch between what patients want in informed consent and what they receive. Advertising affects patients' expectations and satisfaction with care. Conflicts of interest primarily function at an institutional level. There is inequity of access, which affects surgeons' portrayal. We propose research, self-reflection, understanding patient values, professionalism, managing expectations and advocacy as means to address ethical issues in implementing robot-assisted surgery. Conclusion: Empirical research on patient perspectives does not support all theoretical concerns regarding ethical issues in implementing robot-assisted surgery. The non-technical skills required for patient-centred implementation are already encompassed in the role of a surgeon.