In 1994, the AESOP 1000 surgical robot, a surgeon-controlled arm that could be deployed using either pedals or manual controls, became available for sale on the open market.

For instance, many of the current efforts in robotics involve augmenting the surgeon’s dexterity during minimally invasive surgeries, but this requires substantial research and long-term outcomes data for clinical benefits to be shown.

What is a Robotic Surgical System?

Robotic surgical systems (RSSs) are computerised platforms that provides assistance to surgeons when performing minimally invasive surgery (MIS) designed to enhance clinical results for patient and is typically consisted of a master console with two or three robotic arms equipped with wristed instruments, a three dimensional endoscopic camera and controlling device which, in join act determine the movements of the surgical acts, performed and directed from the console and executed back from the robotic act feed from the computer system.

All can seamlessly transpose surgeon commands so that robotic systems function as essentially open-ended remote appendages. Surgeons have the ability to manipulate and control robotic arms, which replicate human movements, isolate hand tremors and flexibly extend into hard-to-access spaces. Many commercially available RS are already FDA-approved for advanced surgery.

Since 1985 the first medical robotic device has been in use in healthcare and was employed in 1990s to execute the first ever robotic neurosurgical biopsy [7]. In 2000, the US Food and Drug Administration gave its approval for the use of the da Vinci Surgical System (Intuitive Surgical) as a tool in MIS procedures.

How Does a Robotic Surgical System Work?

Robotic surgical systems have a master console that allows a surgeon’s movements and sight to be directed directly to free-standing servant robotic arms. These robotic servants do not replace the surgeon entirely, but provide him or her with the ability to work over the patient with increased range of motion for instruments, better visualisation of anatomy and less tissue damage.

Robotic surgery is typically minimally invasive. That means it comes through the body without large incisions or substantially through entry ports, and uses long-handled surgical instruments inside to operate and manipulate layers of tissue.

Robotic surgery is safer than open or laparoscopic and has less trauma, pain, hospitalisation time and recovery time – and possibly better aesthetics – than other surgical approaches.

To date, robotic interfaces for such work are largely available in hospital settings that use only select systems with improved image capability, haptics, and miniaturised tools. Research in other new systems with improved image capability, haptics, and miniaturised tools is ongoing. There are also plans to move forward with developing surgical training simulators to practise surgical techniques before stepping into the operating room. Researchers predict that improvements with the new systems will be made in terms of reducing the learning curve and boosting surgeon confidence for using a robotic approach.

What are the Benefits of a Robotic Surgical System?

Robotic surgery can be used for hernia repair, treating achalasia (a condition where swallowing does not work), and several cancer treatments. Robotic surgery can greatly improve the speed of healing, and often involve patients being discharged much sooner, which saves medical costs.

It is the surgeons, however, who operate the robotic system from a console located a few feet away from the patient’s body, where their movements of the hands, wrist and fingers are in real time translated into those of the system’s arms; 3D images of the site of surgery are also provided by this console, as is a 3D view of the surgical site should there be available surgical assistants or scrub nurses on the surgical team to help surgeons switch instruments as needed.

Robotic surgery systems become another means to expand a surgeon’s operative repertoire and enable him or her to perform more complicated or difficult tasks more expeditiously, if only one had the time and inclination to learn how to do it. I vividly recall once scheduling students for a robotic surgery course. One- and two-day courses for instruction seemed to proliferate and be considered a sufficient period of training, but one of the students had told me that after performing an operation at the end of the course and being sued for malpractice (for an unexpected outcome) it explained why the course was only one day long. Today however, during the general surgery residency program, I discovered that residency programmes carry components for robotics, so residents become more comfortable with this technology throughout their training.

What Are the Risks of a Robotic Surgical System?

Robotic surgery involves minuscule incisions, minimal muscle damage and faster recovery times than open surgery, helping to make this minimally invasive technique as intuitive for the surgeon as possible, as well as popular among surgeons and their patients alike.

Systems enable a doctor to rehearse highly technical procedures, ranging from advanced surgical techniques to handling newborns. With VR and AR, surgeons can import images captured in real time from their surgical site onto a 3D model on a screen for watching, enhancing the surgeon’s ability to see the anatomy, and sometimes help identify what might be different in a patient’s body compared with the norm.

Whilst there are many benefits to robotic surgery, many hospitals are finding it hard to adopt. It can be especially difficult switch to and operating robotic surgical instruments is often different and difficult than the normal technique. It can be a challenge to learn the new way to do surgery and this often leads to poor results when compared with normal surgery.

Real or perceived risks with robotic surgery might deter some individuals from seeking out the procedure; therefore healthcare providers must educate patients on the clinical outcomes data and share success stories to reduce these barriers and foster a relationship with their patients that is built on trust. Furthermore, if a patient is slated to have a procedure with a surgeon who is not as experienced with robotic surgery (ie, not yet having completed at least 300 or 400 robotic surgeries), the hospital should inform a patient.