Rethinking Autonomous Surgery: Focusing on Enhancement over Autonomy

Area of Science:

• Robotics
• Surgical Technology
• Human-Machine Interaction

Background:

• Robot-assisted surgery adoption is rising, driving increased research in surgical automation.
• Automation in surgery promises improved outcomes, task offloading, and workflow enhancement.
• The long-term goal of fully autonomous surgery warrants critical examination.

Purpose of the Study:

• To outline engineering needs for automated surgical control systems.
• To summarize technical hurdles in automated robotic surgery.
• To review sensing and modeling techniques for real-time human behavior integration into robotic control for enhanced collaboration.

Main Methods:

• A nonsystematic literature search was conducted up to March 25, 2021.
• Included studies focused on automation in robot-assisted laparoscopic surgery.
• Human-centered sensing and modeling in surgical contexts were also reviewed.

Main Results:

• Reviewed literature on surgical task automation techniques.
• Identified studies on human-centered sensing, computer vision, and AI/machine learning for skill assessment.
• Examined haptic/adaptive guidance and the limited research on training and autonomy's impact on patient outcomes.

Conclusions:

• Research should prioritize understanding surgeon behaviors, goals, and limitations.
• This understanding can lead to superior collaborative surgical robots.
• Focusing on collaboration, rather than full autonomy, offers a more effective path for surgical robotics.