Initial clinical experience with a partly autonomous robotic surgical instrument server

The authors believe it would be useful to have surgical robots capable of some degree of autonomous action in cooperation with the human members of a surgical team. They believe that a starting point for such development would be a system for delivering and retrieving instruments during a surgical procedure.

The described robot delivers instruments to the surgeon and retrieves the instruments when they are no longer being used. Voice recognition software takes in requests from the surgeon. A mechanical arm with a gripper is used to handle the instruments. Machine-vision cameras locate the instruments after the surgeon puts them down. Artificial intelligence software makes decisions about the best response to the surgeon's requests.

A robot was successfully used in surgery for the first time June 16, 2005. The operation involved excision of a benign lipoma. The procedure lasted 31 min, during which time the robot performed 16 instrument deliveries and 13 instrument returns with no significant errors. The average time between verbal request and delivery of an instrument was 12.4 s.

The described robot is capable of delivering instruments to a surgeon at command and can retrieve them independently using machine vision. This robot, termed a "surgical instrument server," represents a new class of information-processing machines that will relieve the operating room team of repetitive tasks and allow the members to focus more attention on the patient.