Emerging Surgical Robotic Applications for Modern Minimally Invasive Surgery (MIS)

1. Introduction

As the field of surgical robotics steadily advances, surgeons cannot perform minimally invasive surgery with or without the accumulation of endoscopes (Palep, 2009; Theodore et al., 2018; Leal Ghezzi et al., 2016, Barua et al., 2023). Surgical robots are computer-programmable extensions of computers that allow great precision and more delicate surgical techniques (Wedmid et al., 2011; Herrell et al., 2014; Barua et al., 2022; Tuliao et al., 2014). The first application of robotics in neurosurgery was a biopsy (Sackier et al., 1994). Neurosurgery may have been the pioneer of robotic surgery, but due to anatomical constraints, the idea of robotic surgery was extended to other areas such as urology, gastroenterology, etc (Ahmed et al., 2018; Jølner et al., 2022; Herling et al., 2017). The major obstacles to the advancement of robotics in neurosurgery are anatomical constraints, delicate neural structures, and minimal opportunities for advancement (Zhang et al., 2020; Momin et al., 2020, Lane, 2018). The current system more accurately referred to robots as co-robots or “cobots” because they work in conjunction with human operators rather than autonomously (Javaid et al., 2022). Growth and development have been immense over the past two decades. In 2015, more than 700,000 surgical procedures were performed using the da Vinci system (Shin et al., 2020). Robotic surgery can be classified based on the working environment, manipulator design, target structure, methods, or degree of autonomy (de Smet et al., 2018; Peters et al., 2018; Barua et al., 2022). For better understanding, it is generally divided into active and passive systems. Figure 1shows the engineering design, fabrication methods, and human-robot interaction technologies of soft surgical robots for MIS. In a passive system, also known as a master-slave relationship, the robot is the passive unit while the surgeon operates the physical tool. The active system, on the other hand, provides a much higher degree of autonomy to the robots, with the surgeon intervening only when needed (Panteleimonitis et al., 2018; Morrell et al., 2021). Figure 2 shows different surgical (MIS) tools. An intermediate form of these two systems is the semi-active system, in which the robot provides some assistance to the surgeon in performing the procedure (Gettman et al., 2016). An example of this is the Neuromate system (Elsabeh et al., 2021). Robotic surgery is a rapidly developing field of medicine with a fascinating past (Theodore et al., 2018; Leal Ghezzi et al., 2016). Although Intuitive Surgical's supremacy and hegemony, the progress of robotic surgery is far from complete, with a number of possible rivals on the horizon pushing the limits of the best technology (Shin et al., 2020; Kajita et al., 2015).