Medical Devices and Healthcare IT

Trends, challenges behind robotic surgery

25 June 2023

Surgical robotics is a precise approach whereas robotic-enabled tools assist the human surgeon to perform surgeries that demand the highest level of precision. Though the first notion of robotic-assisted surgery began in the late 1960s, it was not until the late 1980s that robotic surgery became actualized. Robodoc (Integrated Surgical Systems, Sacramento, California), spurred early adoption by way of their orthopedic image-guided system developed by Hap Paul, DVM, and William Bargar, MD, for use in prosthetic hip replacement, which ushered robotic surgery into a trending topic among the medical community.

Producing even more satisfactory proof of concept, the U.S. Department of Defense (DoD), alongside a group of independent research institutions and related stakeholders, produced a viable multipurpose surgical robot and set a grand stage for what is now a growing industry. Surgical robotics are now enjoying a robust phase of developmental refinements.

Source: Monopoly919/Adobe StockSource: Monopoly919/Adobe Stock

Presently, the most prominently available multipurpose robotic surgery system with U.S. Food and Drug Administration approval is Intuitive Surgical Inc.'s da Vinci Surgical System, which is enjoying momentous adoption in surgical settings across the globe. It is estimated that three out of every four prostate cancer surgeries in the U.S. are performed using the $2 million da Vinci surgical system.

What are the primary benefits of using surgical robotic systems?

Device engineers forever changed the clinical landscape by placing artificial intelligence (AI) approaches in the hands of trained surgeons. However, to be clear, a robot does not yet operate as a standalone device in the operating room as a mainstream standard of care. The robotic assisted systems (RAS) platform operation features multiple robotic arms or extensions that utilize a remote interface with a human surgeon trained on the device.

Digging deep into the modern patient aesthetic, surgical robotics boasts a more streamlined, less invasive experience, consequently making future development prospects even more attractive. Industry thought leaders weigh in on the fact that delivering more satisfactory patient outcomes drives aggressive development in this space.

Moreover, health care systems appear universally committed to adopting patient-centric attributes wherever they may apply. Strategically, RAS align with these initiatives and somehow rationalize the tremendous expense associated with adoption. However, despite the initial overwhelming expenditure to any hospital budget, every side of the clinical fence understands the true scope of benefit:

- The risk of infection and any complications are drastically reduced, which means the patient can expect a shorter duration inside the care of a hospital environment.

- Accessibility to hard-to-reach areas helps reduce surgical scarring because of a more precise route of entry and exit, resulting in less pain for the patient and expedient recovery times.

- The robotic precision involved used to cut through delicate parts of the body lessens opportunities for mistakes by way of human error.

Understanding the power RAS demonstrates to the medical community, its rapid adoption is not surprising. Device engineers deployed robotic surgical systems into an already primed climate. The clinical industry is hungry for low-contact, minimally invasive tools to deliver patient care. The feedback across many clinical sectors is overwhelmingly positive as clinical teams prepare for the next wave of innovations slated to feature a plethora of autonomous robotic systems. This is not to say RASs are not without challenges. There are some big rocks on the pathway that may need to be smoothed out before the robotic engineering industry can push forward without resistance.


The cost of RASs is extraordinary and there are concerns about how to make the investment pay off in the long term. Hospital administrators must consider training, heavy IT security, repairs and ultimately whether adoption will lead to a dulling-down of skills for the surgeon who traditionally demonstrates a certain level of surgical prowess. Akin to historical large-risk medical device innovations, engineering firms will eventually need to wrestle with the far stricter regulatory controls over surgical robots.

There are also some concerns regarding whether use impacts surgeon-focused decision-making, patient trust and perception, and equal accessibility. The deployment of surgical assistance devices is a complex process. Some of the more prestigious training hospitals have even implemented “boot camps” to help get their surgical teams up to speed on new robotic system applications in a way that device engineers can help integrate the technology into clinical rotation.

Applications of use

RAS-enabled surgical techniques are applied in many diverse clinical applications and are still undergoing rampant expansion as a platform for mainstream use. Device engineers are furthering the design components and implementing clever optimization techniques. Subsequently, today’s most refined surgical robotic system, HUGO RAS, makes use of wristed instrumentation, 3D visualization and cloud-based surgical video capture.

This latest generation of robotics systems can facilitate delicate soft-tissue incisions, presurgical mapping and prepping procedures, making it ideal for a myriad of surgery-types. Common AI-assisted operations include gynecologic, orthopedic, colorectal, kidney, prostate and single-site gall bladder surgical procedures. New innovations in robotic-enabled neurosurgery are also contributing to a powerful shift in narrative within this space.

Autonomous robotics as a telepresence in healthcare settings

Autonomous robotic systems are in aggressive testing rotation. Johns Hopkins and other giant medical pillars are focusing heavily on robotic engineering as they launch newly tested autonomous devices into the operating room. There are many sectors within the clinical health system where device engineers are creating AI-enabled robotic systems. Industry experts point to telehealth as a strong area to watch for futuristic robot sightings.

Global projections estimate that the telehealth market size is expected to reach $455.3 billion by 2030. Incorporating robotics into our traditional standard of care situations is a game changer. This translates into a telepresence model capable of performing minor surgical procedures such as biopsies making the shift to remote surgical endeavors a real possibility. Answering this need spans across multiple industries, most notably the military.


While surgical robot disruption is sure to take the world by storm, we can expect some resistance. However, because of increasing patient populations and lack of equity access to internet and connectivity devices, it seems plausible that robotic engineers are quickly answering two of the most serious of global needs: telepresence in remote areas and a way to service vulnerable and ESL patient populations. Robotics systems as an answer is a clear winner in this regard. Mitigating the more serious concerns associated with RAS hacking and the potential for remote sabotage will no doubt become a pain point for device development teams to address as more of the systems get deployed into mainstream clinical operation.

About the author

Candace Kastanis, a previous laboratory professional, is a freelance medical and science writer. As a California native and resident, she enjoys the outdoors and spending time with her family and friends. Also a creative writer, Candace is excited about her upcoming fictional novel debut.

To contact the author of this article, email

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