Diffusion and adoption of the surgical robot in urology

Abstract

Robotic surgery is rooted in the history of laparoscopic surgery. In 1986, the development of the first video computer chip allowing magnification and projection of images onto television screens sparked a worldwide adoption of laparoscopic surgery (1). This rapid rise of laparoscopic procedures led to an interest in exploring laparoscopy's capabilities in the remote setting, ultimately leading to the development of the first robotic surgical systems. One of the first such systems was the Green Stanford Research Institute Telepresence Surgical System (GTSS), a collaboration between multiple investigators beginning in the 1980s, led by Dr. Phillip Green at Stanford Research Institute (2). This system, similar to contemporary "master-slave" robotic surgical systems, included a remote operative site, surgical workstation, and three-dimensional visualization of the surgical site. However similar to standard laparoscopic instruments, the Green Surgical System's instruments maintained only four degrees of freedom (3). In 1992, this endeavor gathered momentum due to the involvement and funding from the United States Defense Advanced Research Projects Agency (DARPA), which envisioned a robotic tele-surgical system allowing surgeons to perform live remote surgery in the battlefield (4). It was through