Abstract

Just as laparoscopic surgery provided a giant leap in safety and recovery for patients over open surgery methods, robotic-assisted surgery (RAS) is doing the same to laparoscopic surgery. The first laparoscopic-RAS systems to be commercialized were the Intuitive Surgical, Inc. (Sunnyvale, CA, USA) da Vinci and the Computer Motion Zeus. These systems were similar in many aspects, which led to a patent dispute between the two companies. Before the dispute was settled in court, Intuitive Surgical bought Computer Motion, and thus owned critical patents for laparoscopic-RAS. Recently, the patents held by Intuitive Surgical have begun to expire, leading to many new laparoscopic-RAS systems being developed and entering the market. In this study, we review the newly commercialized and prototype laparoscopic-RAS systems. We compare the features of the imaging and display technology, surgeons console and patient cart of the reviewed RAS systems. We also briefly discuss the future directions of laparoscopic-RAS surgery. With new laparoscopic-RAS systems now commercially available we should see RAS being adopted more widely in surgical interventions and costs of procedures using RAS to decrease in the near future.

Highlights

  • In the year 1986, a team using a modified UNIMATION PUMA 200 programmable industrial robotic arm performed the very first robotic assisted surgery (RAS)

  • Intuitive Surgical Inc. and Computer Motion were both awarded important patents related to their robots, resulting in both going to court to settle an ongoing patent dispute

  • Before the patent dispute was settled in court, Intuitive Surgical bought out Computer Motion including the disputed patents, ending the patent battle

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Summary

Introduction

In the year 1986, a team using a modified UNIMATION PUMA 200 programmable industrial robotic arm performed the very first robotic assisted surgery (RAS). The surgical procedure used the PUMA 200 robot to obtain a biopsy from a patient with a suspected brain lesion [1,2] Since this first successful use of a robot to assist in a surgical procedure, several RAS systems have been developed, but only few of those systems have been commercialized. As a result of Intuitive Surgical’s purchase of Computer Motion, many of the patents relating to laparoscopic RAS were owned by Intuitive Surgical up until recently when they began to expire. Many laparoscopic RAS systems were being developed waiting for the patents to expire, resulting in new robots obtaining FDA approval in the past few years. This review will look at the RAS systems that are currently commercialized, those that are currently undergoing clinical testing for approval and those in late prototype stages of development. This review will take a sub-system approach to comparing and contrasting the RAS systems, beginning with the subsystems of the surgeons console and culminating in the sub-systems of the patient interface

Literature Review Methods
Literature Review Results
The Robotic-Assisted Surgery Systems
Imaging and Display Technology
Surgeons Console
Seated or Standing
Hand Controllers
Haptic Feedback
Tremor Removal
Patient Interface
Patient Cart
Robot Arms
Trocar
Instruments
Future Directions
Conclusions
Objective
Full Text
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