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Robotic Surgery

A Brief History of Robotic Surgery

The word "robot" was coined through the Czech playwright Karel Capek in 1921 in the play Rossum's Universal Robots.

The word "robot" is in the Czech word robota, which means forced labor. Robots have developed from primitive machines that could perform a variety of menial tasks to current devices that can perform a variety of complex tasks. Robots are utilized in computers, in research, and in manufacturing. Robots only have recently entered the world of medicine. Industrial robots are actually employed for a variety of surgical procedures. The first non-laparoscopic robot was the Puma 560, used in 1985 to perform neurosurgical biopsies with greater precision.

Three years later, Davies et al performed transurethral resection of a bladder tumor using the same machine. Next, ROBODOC was developed by Integrated Surgical Supplies of Sacramento, CA; this robot was developed to allow precise drilling of the femur during hip replacement surgery. ROBODOC became the first robot approved by the FDA.

A variety of commercial companies have developed surgical robotic systems. Computer Motion, Inc. developed the AESOP® Endoscope Positioner: a voice-activated robotic system for endoscopic surgery. The HERMES® Control Center was also developed by Computer Motion, Inc. and brought a centralized voice command and recognition system to the robotic medical devices. Integrated Surgical Systems (now Intuitive Surgery, Inc.) redesigned the SRI Green Tele-presence Surgery system and created the da Vinci Surgical System® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist® technology to mimic natural hand movement. The Da Vinci system was first approved by the FDA in 2000.

In 2001, SOCRATES™ Robotic Tele-collaboration System was developed by Computer Motion, Inc. offering integrated telecommunication equipment combined with a surgical robot to provide the capability for remote surgical telecollaboration. This technology was used for the first trans-Atlantic telesurgery.

Robotic surgery has gained widespread acceptance over the past 15 years. In areas such a prostatectomy for prostate cancer, robotic surgery is now used in over 90% of cases. Other areas are seeing widespread use including coronary artery bypass, heart valve replacement, colorectal surgery, and gynecologic surgery. In 2006 researchers at University of Pennsylvania developed Trans Oral Robotic Surgery (TORS); in 2009 the FDA approved TORS for removal of benign neoplasms and small malignant tumors from the pharynx (throat). The application of TORS for obstructive sleep apnea (OSA) offers carefully selected patients a promising new surgical option for treatment of this disabling disease.