Toward increased autonomy in the surgical OR: needs, requests, and expectations.

Area of Science:

• Surgical technology
• Robotics in medicine
• Operating room efficiency

Background:

• Surgical procedures face increasing complexity due to trauma reduction trends.
• Mechanical systems and automation are becoming essential in surgical workflows.
• Surgeons will increasingly collaborate with automated systems in the operating room.

Purpose of the Study:

• To identify key technologies and methods for enhancing operating room (OR) autonomy.
• To explore the role of automation and intelligent systems in surgical practice.
• To analyze advancements contributing to increased OR autonomy.

Main Methods:

• Analysis of surgical practice.
• Comprehensive literature search of the Medline database.
• Identification of critical aspects, methods, and technologies for OR autonomy.

Main Results:

• Robotic surgical systems enhance OR autonomy through camera control, intelligent instruments, and automated procedures.
• Transitioning from task execution to autonomous decision-making remains a significant challenge.
• Adaptive OR environments, context-aware interfaces, automated tool arrangement, and optimized visualization are crucial.
• Integration of diverse data sources (EHR, imaging, surveillance) can further boost autonomy.

Conclusions:

• Achieving OR autonomy requires incorporating various assistance systems and methodologies.
• The ultimate goal is cognitive surgery, with autonomous surgeon support as a first step.
• Establishing model-based surgery and integrating procedural tasks are essential.
• Structured knowledge is indispensable for advancing OR autonomy.