Abstract
Robotic assisted surgery (RAS) was perceived as the rising star of the minimally invasive surgery (MIS) since its early stages but, its penetration into the general use of surgery was very slow at the beginning. Over the first two decades of its existence, RAS struggled to be accepted as a valid alternative for standard MIS. Despite the promoted benefits offered by the computerassisted telemanipulation, the main limitations were related to the financial burden of the technology, while the real advantages over "classic" laparoscopy were modest. While medical institutions were not happy to support a wider use of RAS, a question related to the surgical expertise and indirectly to the better patients outcomes was raised. Is RAS improving the skills of an average surgeon to be as good as the MIS experts and reaching a higher level for her/his surgical outcomes? As the answer is very complex, and it is related to so many factors, the debate was always marked by many controverses and no conclusions. Often, during those times, an enthusiastic surgeon attracted by robotic technology, happened to be invited to get trained more for laparoscopic skills, rather than encouraged to spending resources for inconsistent benefits for the patients. Moreover, one could often hear during the surgical conferences arrogant quotes such as â??a fool with a tool is still a foolâ? (Grady Booch).
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