The Future of Surgery: A Look at Robot-Assisted Minimally Invasive Surgery (RAMIS)

Posted on: 2023-06-06 13:25:32

The world of surgical robotics is evolving at a remarkable pace, particularly in the realm of Robot-Assisted Minimally Invasive Surgery (RAMIS). RAMIS has been applauded for revolutionizing medical surgery, introducing unprecedented precision, patient safety, and remote accessibility to the surgical arena.

Despite technical and financial complexities limiting the broad adoption of RAMIS, over 60 unique RAMIS robot types are being developed. Fifteen, including the pioneering da Vinci surgical system, have achieved regulatory clearance. The aim is to bring transformative benefits to the healthcare industry.

This article dives into the exciting universe of RAMIS, shedding light on its development, current research directions, and future prospects.

History and Current Research in RAMIS

RAMIS, an innovative surgical method involving real-time imaging, leverages an endoscopic camera to provide feedback from the surgical site. Surgeons then manipulate robotically articulated instruments via a surgical console. The da Vinci surgical system leads this sector, performing over 1.5 million procedures annually.

This surgical technique's adoption varies across different regions, reflecting the healthcare expenditure of the countries. For instance, in the US, which spends 18% of its GDP on healthcare, only 5% of surgeries are performed using robotic assistance.

NASA and DARPA pioneers laid the foundation for this revolutionary technology, and it wasn't long before a new wave of innovators began introducing radical technological changes. Current research directions include hardware implementation, system simulation, imaging, feature automation, and AI-based training and skill assessment.

Advancements in RAMIS

RAMIS advancements can be grouped into five main areas: autonomy, telesurgery, data, and AI, interfaces, and training.

Autonomy refers to the ability of a robotic system to operate independently. RAMIS systems offer assistance and safety support, reaching Level of Autonomy (LoA) 1 and LoA 2. The ultimate goal is to attain higher levels of autonomy.

Telesurgery, the ability to perform surgeries remotely, is becoming increasingly feasible due to advancements in communication technologies, notably 5G and the forthcoming 6G.

The application of AI and Machine Learning (ML) in RAMIS, forming the backbone of Surgical Data Science (SDS), enables large-scale, diverse clinical data to enhance surgical tasks and guidance.

Human-Machine Interfaces (HMIs) in RAMIS allows surgeons to visualize and manipulate surgical instruments remotely. Future improvements include implementing haptic feedback, simulating touch, and integrating new imaging technologies.

Simulation and training are essential for surgeons to use RAMIS systems effectively. These training sessions generate valuable data that can be used to improve the system and gain deeper insights into human capabilities.

RAMIS: From Prototype to Commercial Products

The transition from RAMIS prototypes to commercial products is complex, fraught with regulatory challenges and high investment requirements. Yet, these hurdles have not stopped several companies from making substantial strides in RAMIS development.

The application of AI and ML in RAMIS introduces further complexity, requiring clearly defined criteria for validation and the capacity to handle data heterogeneity, sparsity, and real-time capabilities. It's vital to ensure that systems developed meet the key properties of beneficence, non-maleficence, autonomy, justice, and explicability. International standards bodies are developing new guidelines targeting AI governance, with sustainability discussions underway at the UN level.

While the journey to market can be slow and complicated, RAMIS holds significant potential for improving surgical procedures. The current R&D focuses on hardware and surgical tools, aiming to provide cognitive support to surgeons through AI and ML solutions.


RAMIS is a technological marvel well-received by the public. However, we must also consider stricter safety requirements, ethical considerations, and sustainability as we continue to develop in this field. With continuous research and advancements, the future of RAMIS holds the promise of truly data-driven surgical assistants, marking a new era in surgical procedures.

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