The history of robotic surgery and its evolution: when illusion becomes reality

Abstract

The term “robot” was concepted in the beginning of last century, coming originally from the Czech word “robota”, meaning “labor”. More recently, computer assistance and robotics based in the telepresence and virtual reality concept have been applied to surgical procedures. The application of robots in surgery dates approximately 35 years, experiencing significant growth in the last two decades fueled by the advent of advanced technologies. Despite its recent and brief status in surgery history, robotic technology has already proven its enhanced visualization, superior dexterity and precision during minimally invasive procedures. Currently, the worldwide diffused and predominant robot system used in surgery is Da Vinci by Intuitive Surgical, however robotic surgery evolution is far from over, with multiple potential competitors on the horizon pushing forward its paradigms. We aim to describe the history and evolution of robotic surgery in the last years as well as present its future perspectives.

Robotic‐Assisted Surgery: A Brief History to Understand Today’s Practices

“…With VR, an immersive, illusionary environment is created that changes the user’s sense of awareness of their physical surroundings, triggering a “telepresence.” Eventually, VR equipment was adapted into a wearable head‐mount display (HMD), and the user donned the DataGlove, an interface tool that uses hand gestures to measure the user’s hand positions and orientations to provide haptic feedback for the wearer 8 . The user achieves telepresence by being immersed into a 3D virtual environment 6 with the ability to interact with and control images in that environment.…”

“…Hence, the concept of remote “telesurgery” was conceived, 8 by which a combat medic transfers the wounded soldier into a mobile armored military vehicle containing a robot and surgical equipment 7 . The soldier then undergoes surgery via a surgical robot whose instruments are manipulated by a surgeon in a remote unit 6 . Telesurgery uses telepresence because the surgeon is removed from the patient and performs surgery virtually via the surgical robot 5 .…”

“…Intuitive Surgical, created in 1995, acquired SRI International’s intellectual property 3 and reworked the surgical telepresence system. Their initial robot consisted of two arms to hold surgical instruments and a third arm for the laparoscope and camera 1,6,8 . Their first prototype, Lenny, had wrists capable of seven DOF.…”

“…Gynecologists led the way with MIS early in the 20th century 2 and continued that trend with RAS; general surgeons joined this endeavor in the mid‐1980s 4 . Increasingly, RAS has been gaining acceptance across surgical specialties, 1 including urology (eg, renal, urogenital, prostate surgery), 5 cardiac surgery (eg, thoracoscopic internal mammary harvesting, mitral valve repair), 6 general surgery (eg, colon, 5 gallbladder, 6 Nissen fundoplication 6 ), and gynecology (eg, uterine, ovarian) 5 …”

Robotic Roux-en-Y gastric bypass: surgical technique and short-term experience from 329 cases

“…We believe that capital costs would be amortized over time having a long-term better healthcare assistance with the advent of new robotic platforms by companies across the world, stimulating the market and decreasing technology overall costs 13 .…”