Robotic Surgery overview

With the introduction of robots in surgery during the early 80s, numerous promises came along with their use, many of which did not achieve clinical significance. The advent of minimally invasive surgery and the resulting boundaries for the surgeon due to the length of the instruments, reduction in degrees of freedom, 2D image, and lack of haptics, called on robots to improve these limitations and they once again appeared to show potential. Investments in the field led to the development of three robots (1): Aesop, Zeus, and DaVinci. Neither of those were granted the designation of "robot" by the FDA as none were capable of automated pre-programmed surgical tasks, the official definition of a robot. However, all have led to some clinical breakthroughs. The Aesop was found to be a useful assistant during long laparoscopic surgeries; the Zeus with its bed-mounted feature and ability to use 5 mm instruments, and its telesurgical capability, was used efficiently in pediatric surgery and remote telepresence surgery (2, 3); and the DaVinci, with its 6 degrees of freedom, has improved surgeon's precision to carry out delicate tasks in confined spaces (1). In fact, in recent years, robotic prostatectomy has become the most popular approach to this surgery in the United States and has boosted the prevalence and sale of robotics across the USA. Whilst some may argue that robotic cardiac surgery or telerobotic telepresence surgery may have been a more impressive and groundbreaking demonstration of the capabilities of robotics, it is undeniable that robotic prostatectomy has been the "killer ap" which broke the ice and introduced robotics into the mainstream use. The establishment of Minimally Invasive Robotic Association (MIRA), an international body dedicated to the promotion of robotics in surgery, is a sign of this breakthrough.

Today, with the broader availability of robots, more and more surgeons are evaluating their clinical significance in a wide range of surgeries. Furthermore, uncharted areas of image-guided surgery (4), preplanning and automation are once again of interest to researchers and to industry. Telepresence surgery also continues to garner significant interest and there are ongoing investments for research in this field, particularly by the US military and NASA, the two organizations which should be credited with the early investments that got the ball rolling and the current edition of robots on the market.

WeBSurg is dedicated to presenting the latest techniques and technology to help surgeons and interventionalists keep abreast of these developments and provide an educational platform for their needs. We presented a number of robotic breakthroughs in the past. However with increasing clinical and research applications we have decided to dedicate a new section to Robotic Surgery on WeBSurg. The section, which will be presented in collaboration with MIRA, will include: articles by pioneers in the field, video demonstration of robotic surgery by experts, news of recent developments, new techniques, upcoming robotic conferences and courses.