Review of robotic surgery platforms and end effectors.

In the last 50 years, the number of companies producing automated devices for surgical operations has grown extensively. The population started to be more confident about the technology capabilities. The first patents related to surgical robotics are expiring and this knowledge is becoming a common base for the development of future surgical robotics. The review describes some of the most popular companies manufacturing surgical robots. The list of the company does not pretend to be exhaustive but wishes to give an overview of the sector. Due to space constraints, only a limited selction of companies is reported. Most of the companies described are born in America or Europe. Advantages and limitations of each product firm are described. A special focus is given to the end effectors; their shape and dexterity are crucial for the positive outcome of the surgical operations. New robots are developed every year, and existing robots are allowed to perform a wider range of procedures. Robotic technologies improve the abilities of surgeons in the domains of urology, gynecology, neurology, spine surgery, orthopedic reconstruction (knee, shoulder), hair restoration, oral surgery, thoracic surgery, laparoscopic surgery, and endoscopy.

An introductory review of robotically assisted surgical systems.

PURPOSE: The scope of the work is to present the state of the art of robotically assisted surgical systems and to give a general idea about how technology can help today and tomorrow robotic surgery. The road to innovation passes through research and on field trials; for this reason, not only commercial surgery robots, but also innovative prototype robots, proposed by the Academic world, are presented. DESIGN/METHODOLOGY/APPROACH: Following a short introduction, robotically assisted surgery systems are introduced discussing their architectures and main peculiarities. A further section is dedicated to the key enabling technologies that will make possible to improve current systems and that will lead to a new generation of surgical robotic systems able to meet the patient's needs and facilitate the surgeon's task. Finally, brief concluding comments are given. FINDINGS: The idea of using robots for surgery was born many years ago and in a short time a market demand was created. Today the market is very dynamic, and several new products are updated and created for the execution of both traditional and new procedures. The article provides a guide for the reader who has an interest in this area. ORIGINALITY/VALUE: This paper provides an insight into the commercial robotic surgical systems and a look on research prototypes from academic and industrial worlds.

Design of multi-degrees-of-freedom dexterous modular arm instruments for minimally invasive surgery.

In robot-assisted minimally invasive laparoscopic surgery, dexterity has a high relevance. Ideally, the surgeon should feel like in open surgery with the robotic instrument able to perform all tool motions in a suitably wide workspace. The avoidance of the surrounding organs and the adaptation of the motion of the instrument to the space available in the patient should be carried out by the robot and should not interest the surgeon. The dexterity is improved by increasing the number of degrees of freedom available in the portion of the surgical instrument inside the patient. The trend has been to date to actuate the joints in the instrument using actuators located outside the patient and tendons or other transmissions to reach the joints. This approach presents intrinsic limitations that can be overcome only with a change of the architecture. The article presents a design of surgical arm made of modules joined together in a chain. Each module embeds its actuation and sensing. The arm architecture can be selected to be optimal for a specific patient and surgery. The major criticality of this architectural rethink is if small actuators could provide enough torque to move the chain and apply sufficient surgical forces. Preliminary experiments are presented proving that embedded actuation can be strong and powerful enough. The designs of a variety of modules are carefully described.

Trends in robotic surgery.

Robotic surgery began as a technology-driven innovation but is now becoming a genuine method of improving healthcare effectiveness worldwide. This comprehensive review introduces the current trends, using examples of specific systems to distinguish the various types of robotic surgical devices, from remote handling machines to those performing delicate local interventions. We end by commenting on how to extend existing systems and provide an account of the rapid developments in minimally invasive robotic surgery.