History
The history of surgery spans more than 2,000 years—from the earliest operations described by Sushruta, to medieval procedures of Andreas Vesalius and Ambroise Paré, and then to John Hunter, the Scottish surgeon considered the father of modern surgery.
After centuries of evolution and scientific advancement, a major turning point arrived when Philippe Mouret, a French surgeon, performed the first laparoscopic cholecystectomy on March 17, 1987, for a middle-aged woman.
This historic operation marked a true revolution in surgery and laid the foundation for the development of countless advanced minimally invasive techniques. It opened the era of “minimally invasive surgery.”
Whereas traditional open surgery required long incisions, significant pain, and prolonged recovery, laparoscopic surgery uses small incisions (5–10 mm) to insert instruments and a camera into the body. CO₂ or saline is then insufflated to create a working space for the surgeon.
With the continual advancement of science, robotic surgery emerged. Medical literature records the first robot-assisted procedure in 1985, involving a stereotactic brain biopsy. Three years later, the PROBOT surgical robot was used to perform the first robotic prostate surgery at Imperial College London.
Over time, early robotic systems such as PUMA, AESOP, and ZEUS evolved into today’s highly advanced Da Vinci Surgical System, featuring four robotic arms that can mimic human hand movements with near-perfect precision.
Robotic surgery is still based on laparoscopic principles: small 5–10 mm incisions allow the insertion of instruments into the body.
However, instead of manually manipulating the tools, the surgeon controls robotic arms from a remote console. These arms can rotate 540 degrees, move freely within tight spaces, and perform exceptionally delicate maneuvers.
Robotic systems overcome many limitations of the human hand, such as fatigue during long operations, restricted wrist rotation, difficulty accessing deep anatomical spaces, and limited visualization. Robotic systems offer 3D magnified views, reduced pain, minimal blood loss, fewer infections, and faster recovery compared with open surgery.
Present
Today, robotic surgery can be applied across nearly all specialties that previously relied on laparoscopy—including ENT, neurosurgery, gynecology, gastrointestinal surgery, hepatobiliary surgery, and both adult and pediatric surgery.
In 2000, Ohio State University first applied robotic systems in esophageal and pancreatic surgery—two of the most complex procedures in abdominal surgery.
In 2008, the University of Illinois team performed the first living-donor robotic liver resection, with excellent outcomes.
In thoracic and cardiovascular surgery, robot-assisted procedures now include coronary artery bypass, mitral valve replacement, esophagectomy, and lung resection.
In neurosurgery, robotic systems demonstrate clear superiority by enabling highly delicate movements and precise control under microscopic visualization. Research shows a 5-year survival rate of 40% after complete resection of gliomas, compared with 22% when only 95% of the tumor is removed—highlighting the critical importance of robotic precision.
Ophthalmology also achieved a breakthrough in September 2016, when surgeons at John Radcliffe Hospital, University of Oxford, performed the first robot-assisted eye surgery.
Professor MacLaren controlled a robot capable of manipulating retinal structures smaller than 1/100 of a millimeter.
The delay in adopting robotics for ophthalmology stemmed from the challenge of miniaturizing components to fit the confined space of the eye.
Future
Robotic surgery is rapidly expanding and evolving in many directions.
Researchers at the University of Illinois have developed robotic systems capable of treating head and neck cancers through the oral cavity.
Scientists are also working on remote robotic surgery, where surgeons can operate on patients from anywhere in the world.
Miniaturized nano-robots are being developed to navigate inside blood vessels to detect and destroy abnormal cells.
To address current limitations, new robotic systems aim to restore tactile sensation—transmitting real-time information on temperature, pressure, tissue density, and tension back to the surgeon through advanced sensory feedback mechanisms.
Conclusion
Modern medicine continues to advance through the limitless creativity of humankind, and robotic surgery is one of its most remarkable achievements.
Its emergence, development, and refinement have helped the surgical field overcome challenges that persisted for centuries.
We have reason to hope for a future in which humanity can better conquer disease—where physical and emotional suffering may no longer hold dominion over our lives.