Toward versatile cooperative surgical robotics: a review and future challenges.

Purpose: Surgical robotics has developed throughout the past 30 years resulting in more than 5000 different approaches proposed for various surgical disciplines supporting different surgical task sequences and differing ways of human-machine cooperation or degrees of automation. However, this diversity of systems influences cost as well as usability and might hinder their widespread adoption. In combination with the current trend toward open and modular "plug and play" dynamic networks of medical devices and IT systems in the operating room, a modular human-robot system design with versatile access to cooperative functions with varying degrees of automation on demand is desirable. Therefore, standardized robotic device profiles describing essential functional characteristics of cooperative robotic systems are mandatory.

Methods: Surgical robotics is analyzed from a human-machine interaction perspective to identify generic cooperative robotic device profiles, features and use cases. Therefore, cooperative aspects are introduced from a general point of view. Relevant communication channels used for human-machine interaction are then analyzed, referenced by surgical scenarios. Subsequently, proposed classifications of surgical task sequences and surgical robotic systems are analyzed with a focus on a modular design for cooperative robotics in surgery.

Results: Considerations based on cooperative guidelines are given and features are identified and summarized in a classification scheme used to define distinct generic cooperative robotic device profiles. The latter can be the basis for a modular architecture of future surgical robot systems.

Conclusion: Modular system design can be expanded toward functionalities or different degrees of autonomy, shared or manual control. The proposed device profiles of cooperative surgical robots could lay the foundation for integration into open and modular dynamic "plug and play" networks in the operating room to enhance versatility, benefit-to-cost ratio and, thereby, market spread of surgical robotics.