Robotic surgery: Urologic implications

Current medical robots have nothing in common with the anthropomorphic robots in science fiction classics. They are in fact, manipulators, working on a master-slave principle. Robots can be defined as "automatically controlled multitask manipulators, which are freely programmable in three or more spaces." The success of robots in surgery is based on their precision, lack of fatigue, and speed of action. This review describes the theory, advantages, disadvantages, and clinical utilization of mechanical and robotic arm systems to replace the second assistant and provide camera direction and stability during laparoscopic surgery. The Robotrac(R) system (Aesculap, Burlingame, CA), the First Assistant(TM) (Leonard Medical Inc, Huntingdon Valley, PA), AESOP(TM) (Computer Motion, Goleta, CA), ZEUS(TM) (Computer Motion), and the da Vinci(TM) (Intuitive Surgical, Mountain View, CA) system are reviewed, as are simple mechanical-assist systems such as Omnitract(TM) (Minnesota Scientific, St. Paul, MN), Iron Intern(R) (Automated Medical Products Corp., New York, NY), the Bookwalter retraction system (Codman(TM), Somerville, NJ), the Surgassistant(TM) (Solos Endoscopy, Irvine, CA), the Trocar Sleeve Stabilizer (Richard Wolf Medical Instruments Corp., Rosemont, IL), and the Endoholder (Codman, Somerville, NJ).