Robotics and automation have been used in science and industry for decades, yet there have been few applications of this technology within the medical field until recently.

Two major forces resulted in the application of robotics in medicine:

1. The military needed to provide remote expert surgery by means of robots in the field
2. Videoendoscopic techniques used in the 1980s and 1990s had shortcomings when applied to more complex surgical procedures

In both cases, surgeons needed better binocular visualization, as well as enhanced dexterity and remote instrument manipulation in order for robotic surgery to be viable in medical applications.

While a number of surgical robotic systems have been proposed, the first practical surgical robot was the Green Telepresence Surgery System, which was developed in partnership with the U.S. Department of Defense. This system was designed to provide surgeons with the native and intuitive abilities that were often lost with laparoscopic and thoracoscopic surgery.

Those abilities included:

• 3D visualization
• Dexterous, precise surgical instrument manipulation
• Sense of touch from input of force feedback sensory manipulation

The Green Telepresence Surgery System was designed to allow surgeons to apply their expertise to patients anywhere in world through telesurgery. The significant features of the Green Telepresence Surgery System were incorporated into the daVinci Surgical Robot. For example, in military applications surgeons could operate on soldiers in the field from a remote central location.

The daVinci system (developed by Intuitive Surgical in Mountainview, California) consists of three main components:

1. The Surgical Console with two master controls and an integrated 3D display stereo viewer
2. The Surgical Cart with a camera arm and up to three instrument arms
3. The Vision Cart, which contains camera and image processing equipment

Surgeons sit at a surgical console and operate by placing their fingers into the master controls. Surgeons then move their hands within the console to control robotic surgical instruments. Because the instruments are precisely aligned with the master controls, there is natural and predictable instrument movement within the operative field (patient on operating table). The relationship of the master controls to the instruments within the surgical field, coupled with 3D visualization, helps to provide hand/eye coordination and orientation, as well as the natural operative feel found in open surgery.

Surgeons use a stereo viewer to see a 3D visualization of the procedure. As surgeons at the console move their hands as they would during open-surgery, the daVinci system converts their hand movements into minimally invasive surgical movements at the surgical site. In addition, the system electronically scales the surgeon’s hand movements to correspondingly smaller movements of the instrument tips in the surgical field. The instrument tips have six degrees of movement, and the instrument grip and tip movements, combined, mimic the movements of the human wrist.

Although the daVinci surgical robot was originally intended for cardiac surgical applications, it has been used also for urologic surgery, thoracic surgery, general surgery and gynecologic surgery.