Robotics and allied technologies in endoscopic surgery

Endoscopic surgery was developed in the 1970s and 1980s, with initial work conducted by pioneering surgeons. After the development of laparoscopic cho lecystectomy, the break-through of endoscopic surgery had a great effect on all surgical specialties. Starting with rather simple procedures, such as cholecystectomy, a rapid progression toward more complex procedures, such a s reflux or colonic surgery, took place. It was realized at this time that the existing endoscopic instruments allowed only a limited preciseness when performing the procedures, and part of the information from inside the abd ominal cavity was not available to the surgeon. This prompted a discussion with engineers concerning the development of more advanced technologies to give those performing endoscopic surgery the same quality of information an d manipulation that surgeons have when performing open surgery. These quali ties include (1) instruments and manipulators that allow surgical action un der endoscopic control with all degrees of freedom; (2) devices that provid e surgeons with tactile feedback; and (3) vision systems that provide surge ons with the same quality of visual information as with open surgery, namel y, high resolution, excellent color quality, precise spatial information, a nd a constant clear view for optimal surgical action. At the end of 1999, s ome of the aforementioned quality concepts found their way into the surgica l routine, but most of the concepts are still being developed. Another deca de will pass before endoscopic surgery procedures will be closer to the tec hnological goals.