Surgical Robotics: The Next 25 Years - whitepaper

Some time ago, an interesting white paper was published by most respected British researchers under the UK-RAS initiative. Besides over viewing the SoA, the paper aimed to identify the key challenges ahead:

"Tackling research challenges 

The main factors influencing the successful integration of robotics research in surgical practice are arguably high costs, a lack of institutional coordination and the absence of modular, open-source hardware platforms. 

Research funds are limited and often insuffcient to ensure the prototype robustness necessary for safe deployment of novel technologies into the operating theatre. 

Understandably, entrepreneurs are reluctant to invest large capital sums into the commercialization of early stage prototypes. Recent EU funding schemes such as the Horizon 2020 are attempting to address this issue by encouraging collaboration of academic and industrial partners at the early stage of project proposal. 

Overcoming translational barriers 

Regulatory standards and IP protection are core elements of the UK roadmap, which are also considered crucial for successful technology transfer by the European Union. However, the lack of a standardised framework for surgical robot benchmarking remains a major hurdle in the creation of an open worldwide market. Regulatory bodies should work together towards a common agenda for robotic surgery based on clinical evidence and patient benefts. 

One crucial point of such agenda should be the identifcation of appropriate economic and clinical comparators. As an example, robotic-assisted procedures are usually compared to the corresponding laparoscopic approach, which in some markets still has limited adoption for certain procedures. In such cases, robotic technology has the potential to make the minimally invasive approach more accessible, thus making open surgery a better comparator. 

Finally, surgical expertise plays a crucial role in obtaining a fair comparison between robotic-assisted and traditional surgery. Educational portfolios are just starting to include robotics as part of standard training for surgeons and learning curves can vary according to the version of the robotic system used. Standardization of surgical training programs thus becomes fundamental for generating a cohort of expert robotic surgeons that could validate the benefts of robotic-assistance in the surgical theatre of the future."

Source: UK-RAS