Impact of Surgical Robotics in the Era of Data: A Comprehensive Review of Robot-Assisted Minimally Invasive Surgery

Teleoperated robotic systems for robot-assisted minimally invasive surgery (RAMIS) have gained widespread clinical acceptance, making it the first domain in medical robotics to achieve global adoption. Despite its relative success, with limited market penetration, the reliance on human control in this approach ensures that the surgeon remains accountable for the clinical outcomes achieved by the robot. However, there is a growing demand for improved surgical performance, traceability, and safety that surpasses human capabilities, leading to a need for advancements in telesurgical robotics. Challenges such as technical complexity and financial constraints have hindered the full realization of telesurgical robotics' potential. While the da Vinci surgical system dominates the market, there are over 60 emerging RAMIS robot types, with 15 already obtaining regulatory clearance. This review article aims to bridge technological advancements with commercialization principles, particularly focusing on engineering components that can significantly enhance clinical practice. Current RAMIS robots primarily rely on their mechatronics capabilities, lacking data-driven assistance and intelligent human-machine collaboration. However, emerging RAMIS systems are integrating computer assistance, offering enhanced manipulation capabilities, refined sensors, advanced vision, task-level automation, smart safety features, and data integration. This heralds a new era in telesurgical robotics, infused with machine learning (ML) and artificial intelligence (AI) solutions. Robust AI algorithms necessitate high-quality data acquired and shared in real time, enabling ML-based solutions. This review explores historical and future perspectives of emerging RAMIS technologies, considering their potential impact on the field. This article serves as a comprehensive review, examining the latest developments in robot-assisted minimally invasive surgery. It offers an in-depth exploration of key emerging technologies associated with next-generation systems.