Robots entered the operating room around 2000 in the USA following several successful research projects sponsored by DARPA. Since that time, Intuitive Surgical’s da Vinci machine has become the dominant player in robotic surgery with over 4,000 of these multi-million-dollar devices placed in hospitals around the world. In 2018, surgeons will use these robots to perform nearly one million procedures. However, da Vinci is far from the only robotic platform in the OR. Patients will find the Mazor X performing spinal procedures, the Stryker Mako and the Globus Excelsius performing hip and knee replacement, the Stereotaxis Niobe ablating nerves in the heart, and the TransEnterix SenHance and handheld Endocontrol Jaimy assisting with laparoscopic abdominal cases. Robotic assistance of complex surgical procedures has become a very active growth industry that is impacting both the delivery of care to patients and the management of internal resources within the hospital. There are currently nearly two dozen robotic assistance devices approved in the USA and EU and another two dozen that have been announced in the final phases of R&D or regulatory approval.
All these robots aid human surgical teams in performing procedures for which earlier, more manual tools are not well designed. The kind of mechanical and electrical assistance that can be provided with robots was unimaginable just a few decades ago when surgeons and engineers created the current toolbox of surgical instruments. But the success of Intuitive and the companies listed above has shown the power of reimagining surgical tools to allow the latest technologies to extend the skills of the surgeon in performing more precise actions within the human body. This trend is just a couple of decades old, but it points to a future in which almost every surgical procedure and instrument is redesigned to take advantage of advanced materials, mechanical capabilities, electronic and computer controls, integration with healthcare IT infrastructures, and eventually intelligent advice from cloud-based AI.
The robotic systems that exist today deliver both advantages and challenges in the delivery of patient care.