Surgical robotics — Born in space

Abstract

With the introduction of telerobotic systems, it has become possible for surgeons to perform medical operations at greater physical distances from their patients. Whether in an adjacent room or on another continent, these systems enable greater flexibility in mitigating adverse surgical conditions. These ideas originally came from the space research, where further needs emerged to advance robots that could resolve surgical cases previously not treatable. The concept of providing surgical aid to astronauts in outer space yielded to telerobotic surgical care on Earth, benefiting around 1 million patients per year. As the field continues to develop and becomes more prevalent, it is worth looking back to the origins of the technology and the early days of robotic telesurgery. While many of the early prototypes and technologies never reached patients, their engineering components and innovative concepts directly lead to the birth of modern surgical robots.

Robot-assisted surgery in space: pros and cons. A review from the surgeon’s point of view

“…It is well known on Earth that robotic technology is able to extend the surgeon's dexterity and capabilities to perform many types of complex procedures through tiny incisions with the aid of dedicated surgical instruments. The surgical robots used in clinical activity are master-slave telesurgery devices (Robotic-Assisted Minimally Invasive Surgery-RAMIS) entirely teleoperated by the surgeon, in charge of higher level planning and cognitive decision-making, while robots are responsible only for mechanical implementation 36,37 . Its peculiarity is the presence of "a human-in-the-loop-control" 5,6,36,37 and safety provided by the surgeon performing the procedure.…”

“…The surgical robots used in clinical activity are master-slave telesurgery devices (Robotic-Assisted Minimally Invasive Surgery-RAMIS) entirely teleoperated by the surgeon, in charge of higher level planning and cognitive decision-making, while robots are responsible only for mechanical implementation 36,37 . Its peculiarity is the presence of "a human-in-the-loop-control" 5,6,36,37 and safety provided by the surgeon performing the procedure. An evolution of this condition is the possibility to benefit from special features and effectors 5 .…”

“…These Authors reported that, in addition to advances in robotics that have allowed the exploration in harsh environments in space, supporting astronauts operations, Robotics has helped to significantly reduce the cognitive load on humans abundance of critical decisions that must be taken in a timely manner to ensure safety 39 . Depending on the distances between the spacecraft and the Ground Control Center, different telepresence technologies may provide the best performance 30,36,37 among telesurgery, image-guided surgery and cooperatively controlled surgical robotics. Pre-and-intraoperative imaging and physiological data collection shall supply the surgical robot with information to gain more autonomy, future target of Earth and space research 30,36,37 .…”

Review of Advanced Medical Telerobots

“…This successful experience has shown the feasibility and potential to use telerobotic systems for telesurgery in rural and underprivileged areas. At a higher distance, since 2004, the National Aeronautics and Space Administration (NASA) has conducted experiments on remote laparoscopic surgery for astronauts in space conditions, initially with a Zeus robot [57]. The main difficulty, in this case, was a significant time latency.…”

Manipulator Control System for Remote USG Examinantion

“…Such circumstances provide an incentive for the development of many types of telemedicine-related services, ranging from telerehabilitation [22], teledentistry [10], etc. to telesurgery [28]. Medical robots are successfully employed in numerous telemedicine systems.…”