Surgeries of the future: 5 surgical robots changing the operating theatre

Surgical robotic systems empower surgeons to perform more precise, accurate and replicable results, leading to improved patient outcomes. The leading surgical robot is the DaVinci system which was the worlds first surgical robot to be FDA approved in 2000. Since then there have been a number of companies building exciting robotics systems in this space, and according to Markets and Markets the industry is expected to grow from $6.7 billion in 2020 to $11.8 billion by 2025.

So, here are 5 surgical robots that are changing the face of the operating theatre.

1. Rosa by Zimmer Biomet #

The Rosa System by Zimmer Biomet is a robot that can be used for minimally invasive spine and brain surgery. The image above shows the spine system, but they also develop a knee robot.

An interesting feature about the Rosa knee system is that it sends live feedback of the soft tissues in the knee back to the surgeon. This is important as it allows the surgeon to collect real time information about the procedure and how the knee is responding to treatment. This way, a more personalised treatment can be offered to the patient compared to only having data before/after the procedure.

Key facts #

• The knee system received FDA 510(k) approval to market in 2019. The spine and brain system were approved in 2015 and 2016 respectively

• The spine and brain system uses the same chassis, decreasing costs and training time

• As of 2019, 100 Rosa systems were installed in the US

2. Mako by Stryker #

The Mako System is designed for joint surgery, and empowers surgeons to perform partial knee, total hip and total knee procedures.

Mako utilises pre-operative planning data by converting the bone in CT scans to a 3D model that the surgeon can review. This data allows the surgeon to modify their plan before surgery and apply operations directly to the model. Once the surgeon is happy with their plan, it is loaded onto the robot and the saw blade is locked into place relative to the position of the final plan. The robot limits where the saw can go in space whilst being manipulated by the surgeon.

For all you computer vision loving readers, the pre-operative model generation process involves 3D segmentation of the bone in the CT images, usually via its bright intensity (caused by the Hounsfield unit of bone). This segmentation can be refined into a mesh and the number of polygons reduced for computational efficiency.

Key facts #

• Mako was FDA approved in 2015

• In 2019 there were 650 Mako robots installed globally

3. NAVIO by Smith & Nephew #

The NAVIO surgical system by Smith and Nephew is another knee replacement robot. It is similar to ROSA in that it also creates a 3D map of the knee bone for the surgeon to pre-operatively plan trajectories. Instead of CT images, there is real time mapping and registration of the bone through landmark collection and point mapping.

This system is incredibly exciting, as it means the patient does not have to be exposed to harmful radiation to acquire a 3d model of the bone, and data collection is quicker. These factors drastically reduce total operation time.

Key facts #

• Received FDA clearance in April 2018

• Currently the only handheld robotics system available for knee surgery

4. Versius by CMR Surgical #

The Versius robotic system by CMR Surgical, a Cambridge (UK) based company, has been designed for keyhole surgery - well known as a complex and demanding procedure. It is similar to the famous Da Vinci system, the first robot to be approved for keyhole surgery in 2000.

Versius has a modular set of arms, meaning the arms can be added/removed depending on the requirements of the procedure. This is because each arm is on a seperate wheeled cart - it can also easily be moved from room to room because of this. A HD camera at the end of each arm allows the surgeon to see the procedure clearly.

Key facts #

• The first use of Versius in a European hospital was in Edinburgh in 2020, and the first installation of Versius was in a German hospital in 2021.

• At the time of writign, Versius is not yet FDA approved, but maybe this is on the horizon for CMR surgical

5. Flex Robotic System by MedRobotics #

The Flex Robotic System offers surgeons visualization and surgical site access to the oropharynx, hypopharynx, and larynx in their patients - locations previously difficult to access minimally invasively. The body of the robot has numerous links that allow it to move non-linearly through the body (in comparison to a straight or rigid tool). Once the scope is in position, the surgeon can deploy instruments through the body of the robot, like the 3mm fenestrated grasper in the image. Other tools include scissors, a laser holder or a needle knife.

Key facts #

• The Flex Robot system was FDA approved in 2017

• Surgeons can see a HD view of the site from the onboard cameras

• The Flex robot can navigate difficult to access locations in the body due to it’s flexible concentric links.