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Review
. 2018 Oct-Dec;22(4):e2018.00039.
doi: 10.4293/JSLS.2018.00039.

Origins of Robotic Surgery: From Skepticism to Standard of Care

Evalyn I George  1 , Timothy C Brand  1 , Anthony LaPorta  2 , Jacques Marescaux  3 , Richard M Satava  4
Affiliations
Review

Origins of Robotic Surgery: From Skepticism to Standard of Care

Evalyn I George et al. JSLS. 2018 Oct-Dec.

Abstract

Background and objectives: The uses of robotics in surgery were hypothesized as far back as 1967, but it took nearly 30 years and the nation's largest agency, the Department of Defense, in conjunction with innovative startups and established research agencies to complete the first fully functional multipurpose surgical robot. Currently, the most prominently available multipurpose robotic surgery system with US Food and Drug Administration approval is Intuitive Surgical Inc.'s da Vinci Surgical System, which is found in operating rooms across the globe. Although now ubiquitous for minimally invasive surgery, early surgical robot prototypes were specialty focused. Originally, multipurpose robotic systems were intended for long-distance trauma surgery in battlefield settings. While there were impressive feats of telesurgery, the marketable focus has veered from this goal. Initially developed through SRI International and Defense Advanced Research Projects Agency, surgical robotics reached private industry through two major competitors, who later merged.

Methods: A thorough search of PubMed, Clinical Key, EBSCO, Ovid, ProQuest, and industry manufacturers' websites yielded 62 relevant articles, of which 51 were evaluated in this review.

Conclusion: We analyzed the literature and referred to primary sources by conducting interviews with present and historical leaders in the field to yield a detailed chronology of surgical robotics development. As minimally invasive robotic procedures are becoming the standard of care, it is crucial to comprehensively document their historical context and importance as an emerging and evolving discipline.

Keywords: History; Robotic; Surgery.

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Conflict of interest statement

Conflict of interest: Jacques Marescaux is the president of both IRCAD and IHU Institutes, which are partly funded by Karl Storz, Medtronic, and Siemens Healthcare. Ms George and Drs Brand, LaPorta, and Satava have nothing to disclose. These views are those of the authors and not of the US Department of Defense.

Figures

Figure 1.
Figure 1.
Head mounted display (HMD) with DataGlove interface, a theoretical controller for a telerobotics system, demonstrated by Dr. Scott Fisher.
Figure 2.
Figure 2.
([bdit]A) COL Anthony LaPorta operating at TSW. ([bdit]B) Early version of the TSW (note the ergonomic design, adjustable stool, and armrest to stabilize and rest the arms). ([bdit]C) TSW master controls, reengineered from a standard surgical instrument.
Figure 3.
Figure 3.
([bdit]A) Remote surgical unit being used to create an incision. ([bdit]B) Exchangeable end effectors for SRI's RSU. ([bdit]C) RSU end effector with instrument attached.
Figure 4.
Figure 4.
DARPA's original concept for MEDFAST surgical unit, linked by mobile 2-way microwave communication link.
Figure 5.
Figure 5.
Clamped ([bdit]A) and femoral artery ([bdit]B) repair performed with SRI's Telepresence System.
Figure 6.
Figure 6.
Two-layer gastrotomy closure performed with SRI's Telepresence System.
Figure 7.
Figure 7.
Computer Motion's ZEUS in an operating room.
Figure 8.
Figure 8.
Lenny, Mona, and da Vinci patient-side manipulators.
Figure 9.
Figure 9.
Lenny, Mona, and da Vinci master controllers.
Figure 10.
Figure 10.
Timeline of surgical robotics development.
See this image and copyright information in PMC

References

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