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INNOSC Theranostics and
Pharmacological Sciences Robotics in modern surgery and critical operations

shift driven by robotic technologies. The development are highly stressful for surgeons. Robotic systems allow
of artificial intelligence, miniaturization, and increased surgeons to perform operations while seated comfortably,
computing power are expanding the range of medical and unlike humans, robots do not experience fatigue.
applications for robots. Over 34 years ago, an industrial Their “hands” are typically rigid and steady, allowing
robot and computed tomography navigation were first them to maintain stability and precision during prolonged
used successfully to insert a probe into a patient’s brain procedures. One of the main advantages of robotic surgery
to obtain a biopsy sample, marking the beginning of the is the exceptional precision and accuracy it provides in
field of medical robotics. This breakthrough was followed catheter-based or surgical operations. The primary aim
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by the development of robots designed to perform certain of our review is to explore the application of robots in
urological treatments and total hip arthroplasty. However, modern surgery and critical operations.
these autonomous robots did not initially gain widespread
acceptance among surgeons, leading to the development 2. Application of robotics in critical
of later models that were designed to be controlled by surgeries
doctors. Today, medical robots are recognized for their 2.1. Robotic-assisted cardiac surgery
significant contributions to critical surgeries. More
specifically, the use of robots, computers, and software The most common method of myocardial protection in
to manipulate surgical tools with high precision through robotic-assisted surgery (RAS) for intracardiac repair
one or more incisions is one of the most prominent involves placing an aortic cross-clamp and administering
applications of medical robotics, particularly in fields such cardioplegia, similar to traditional open-heart surgery.
as orthopedic surgery, cardiac surgery, neurosurgery, and However, installing an aortic cross-clamp may complicate
telesurgery. Robotic manipulators in medicine are not surgery and perioperative outcomes in patients who have
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limited to surgery; for example, a brain-machine interface previously undergone cardiac surgery with mediastinal
(BMI) and a visual guiding system can provide shared adhesions or those with severe aortic calcification.
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control of a robotic arm in autonomous robotic grasping Robotic assistance may offer additional benefits for
systems, as described by Dzedzickis et al. A BMI is tricuspid valve replacement or repair without the need
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utilized to determine a user’s intention to grasp or transfer for cross-clamping. The emergence of an atrioventricular
an object, while visual assistance helps with tasks that block can help identify and promptly treat damage to the
involve low-level control, short-range motions, and the atrioventricular node caused by sutures placed through the
precise alignment of the robot’s end-effector for grasping. septal portion of the tricuspid annulus, thus eliminating
Experiments have demonstrated that shared control of the need for pacemaker implantation. Furthermore, the
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robotic movements leads to more precise, effective, and da Vinci Surgical System (Intuitive Surgical, United States
straightforward task completion compared to using BMI of America) is one of the most advanced robotic systems
alone. In critical surgeries, achieving precision can be used in cardiac surgery. This system consists of a console
challenging; however, the ability to view the surgical area (from which the surgeon operates), a high-definition
in three dimensions (3D) with high clarity allows surgeons 3D vision system capable of magnifying images up to
to perform procedures with greater accuracy and control. 10 times, and a side robotic cart with four robotic arms
It is estimated that the da Vinci system, which received that the surgeon can control from the console. Three of
the United States Food and Drug Administration (FDA) the robotic arms are used for surgical instruments, while
approval in 2000, has been used in more than six million the fourth controls the camera. In laparoscopic or video-
surgical procedures worldwide, becoming the first robotic assisted thoracic surgery, the 3D endoscope provides better
surgical system. Robotic systems offer several advantages depth perception than conventional two-dimensional
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for both patients and surgeons, such as shorter recovery endoscopes. The surgeon at the console has complete
times, reduced blood loss, and smaller incisions. The long- control over the camera’s orientation and positioning,
term outcomes of robotic surgery are comparable to those which is not the case for the table-side surgical team.
of conventional surgery, although occasional malfunctions The da Vinci S and da Vinci Si systems, the second
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may occur. When compared to traditional laparoscopy, and third generations of this technology, offer easier arm
advanced laparoscopic techniques offer surgeons enhanced movements and broader instrument reach compared to
ergonomics and dexterity. However, the high cost of robotic the first-generation model. The da Vinci Xi is the fourth-
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systems and the need for specialized training for physicians generation model, featuring additional enhancements
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and surgical teams remain significant drawbacks. Robotic such as a laser targeting system for easier robotic arm
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surgery reduces operator fatigue and human error, as setup, thinner arms and instruments with longer reach,
it is less physically demanding than traditional surgery. a movable endoscope that can be attached on any of the
Cardiac surgeries, for example, can last for many hours and four robotic arms, and an overhead architecture/patient-

Volume 8 Issue 3 (2025) 13 doi: 10.36922/itps.4664