Robotics in urological surgery: Review of current status and maneuverability, and comparison of robot-assisted and traditional laparoscopy

Figures & data

Table I.  Broad classification of surgical robotic systems.

Surgical robot system types	Description and potential applications
Passive robots: Have no power; static mechanical fixed devices.
Pre-robots: Omni-Lapo Tract (Omnitract), Iron Intern (Automated Medical Products), Surgassistant (Solos Endoscopy), Trocar Sleeve Stabilizer (Richard Wolfe), Bookwalter retraction system (Codman), Robotrac system (Aesculap), First Assistant (Leonard Medical), Endex laparoscopic holder (Andronic Medical)	Pre-robots are the first-generation passive robots that are basically used as retractors/adjuncts to current robotic systems
Semi-active synergistic robots: Have some degree of autonomous motion.
LARS (Laparoscopic Assistant Robotic System) (Johns Hopkins and IBM) [24]	Semi-active synergistic robot with 4 DOF. Used in experimental surgery only.
Acrobot (Active Constraint Robot) (Imperial College, London) [25]	Used to cut bone with precision and safety in preparation for knee replacement and hip resurfacing.
Steady-Hand robot (Johns Hopkins)	Designed for micromanipulation.
NeuroMate (Integrated Surgical Systems) [26]	For image guided stereotactic neurosurgery.
Active robots: Have a high degree of independent powered motion.
AESOP 3000* (Automated Endoscopic System for Optimal Positioning) (Computer Motion) [27]	Camera-holder robot with 3 DOF. First lap. robot to receive USFDA approval. Voice-controlled arm. Used in micro/ENT/neuro/cardiac valve surgery.
EndoAssist* (Armstrong Healthcare) [27]	Head-mounted navigation system using sensor to track surgeon's head movements.
ROBODOC* and ORTHODOC* (Curexo Technology) [28]	Orthopedic robot (rotary bone cutter) works in conjunction with ORTHODOC computer workstation.
CyberKnife* (Accuray) [29]	For stereotactic radiosurgery.
PROBOT (Mechatronics in Medicine, Imperial College, London) [30]	Computer-controlled robot for TURP.
PAKY-RCM robot	For image guided percutaneous access.
AcuBot* (CT robot) [22]	For image guided percutaneous access.
MR robot [21]	For image guided prostate biopsy/brachytherapy.
Master-slave robotic systems
ZEUS (Computer Motion)	Thoracic and abdominal lap. surgery.
ARTEMIS (Advanced Robotics & Telemanipulator System for MIS) (Karlsruhe Research Center)	Experimental twin master-slave manipulator system for abdominal and thoracic MIS.
da Vinci* and da Vinci S* (Intuitive Surgical)	For urological/non-urological lap. surgery.

*Systems that are currently in clinical use; lap. = laparoscopic; MIS = minimally invasive surgery.

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