Robo

Abstract

This chapter provides an overview of the evolution of robotic surgery over the years, as well as the efforts undertaken in the integration of imaging, sensing, and robotics for improved human–robot interaction. It analyzes robotic platforms and technologies that have contributed to making robotic surgery a major area of innovation and development. Several exemplar platforms from both commercial and research organizations are reported here, categorized, and discussed. On the basis of the classification proposed by Bergeles et al. [1], we focus on different generations of robotic surgery. From one generation of robotic systems to the next, perception, decision, and action are becoming increasingly intertwined, resulting in improved control, dexterity and precision, and reduced invasiveness, access trauma, and tissue damage.

About this book

Robotic surgery is the fastest growing area in surgery worldwide. This growth has touched every single specialty, but it is seen most prominently in general surgery. Since The SAGES Manual of Robotic Surgery was published in 2017, the increasing utilization of robotic surgery has led to advances in technique, technology and even indications for the use of robotic procedures. Innovation has been at the forefront with development of newer robotic platforms. This revised and updated second edition provides a comprehensive review of indications, best practices and advancements in technique over a wide variety of robotic procedures. 

The manual will be divided in sections. The first section includes chapters providing a general review of available robotic surgical systems, including future innovations and platforms. The second section focuses on specific procedures based on the various SAGES Masters Programs. The third section is comprised of chapters on miscellaneous but prominent and upcoming robotic areas, such as thoracic, breast, transplant and cardiac procedures. All sections are accompanied by plentiful color figures and photos, as well as high-quality surgical videos.

Like its predecessor, this manual provides a detailed review of robotic surgery and is geared towards surgeons at all levels of training and experience. It also addresses the needs of surgeons across various sub-specialties. In addition to providing insight into individual procedures, the general review of the system will be beneficial to those who are brand new to the technology. 

Background

Robotic surgical procedures continue to increase both in the United States (US) and worldwide. Several novel robotic surgical platforms are under development or undergoing regulatory approval. This review explores robotic platforms that are expected to reach US consumers within the next 2–3 years.

Methods

The SAGES Robotic Platforms Working Group identified robotic surgery platforms in various stages of development and selected multi-visceral systems nearing or completing the US Food and Drug Administration (FDA) approval process. We outline key system components including architecture, unique features, development status, regulatory approval, and expected markets.

Results

We identified twenty robotic platforms that met our selection criteria. Ten companies were based in North America, and ten were based in Europe or Asia. Each system is described in detail and key features are summarized in table form for easy comparison.

Conclusion

The emergence of novel robotic surgical platforms represents an important evolution in the growth of minimally invasive surgery. Increased competition has the potential to bring value to surgical patients by stimulating innovation and driving down cost. The impact of these platforms remains to be determined, but the continued growth of robotic surgery seems to be all but assured.