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Advances in medical technology have made it possible to perform safer and more accurate surgeries in recent years. surgical support robots play a central role in this. surgical support robots which achieve precision beyond the limits of human hands and reduce the burden on the surgeon, are bringing about revolutionary changes in modern medicine. Starting from this time, we will explain cutting-edge medical equipment over a four-part series. In the first part, we will summarize the current situation and outlook for surgical support robots.

The field of surgical support robots has evolved and diversified rapidly in recent years.

Intuitive Surgical's da Vinci, the world's most widely used surgical robot, is a four-arm system equipped with a stereoscopic view using a 3D high-resolution camera and the ability to precisely reproduce the movements of a human hand. The surgeon operates it from a dedicated console, making it possible to carry out delicate work in small spaces that were previously difficult. Insurance coverage has expanded, particularly for urological surgeries, and now it is possible to perform surgeries covered by insurance in gastrointestinal surgery and gynecology as well. It has been introduced in many of Japan's major university hospitals and occupies a high share of surgical support robots.

The development surgical support robots in Japan is also progressing steadily. "Hinotori," developed by Medicaroid, is equipped with a multi-joint arm, yet has a more compact design and intuitive operability. In particular, the slim arm makes it easy for even small Japanese women to use. It is designed to fit the space and surgical style of domestic operating rooms, and has begun to be used in the fields of urology and gastrointestinal surgery.

Furthermore, in 2023, two national universities, Tokyo Institute of Technology and Tokyo Medical and Dental University, will※Saroa, surgical support robots jointly developed by Saroa and Riverfield, has been released. Unlike Da Vinci and Hinotori, this system features a force feedback function that transmits the sense of touch to the hand. Unlike other robots that rely only on vision, this system allows for safer surgery. It has a compact design and high operability, while making it possible to reduce implementation costs compared to conventional systems.
*The two universities will merge in October 2024 to become Tokyo University of Science, a National University Corporation.

Developed by Medtronic, "Hugo" employs a modular design that allows for flexible placement in the operating room, and its open console facilitates smooth communication between the surgeon and the surgical team.

Asensus Surgical's "Senhance" system is based on the concept of using a robot to operate a laparoscope. It can use the laparoscopic forceps scopes already owned by the hospital, and the surgeon's operation in the cockpit is the same as that of laparoscopic forceps, so it is said to be easy to use for doctors who are familiar with laparoscopes. It features a unique eye tracking technology and an innovative function that controls the camera according to the surgeon's eye movements. It also has a haptic feedback function, which allows the surgeon to feel the texture of more delicate tissues. It is also calculated as laparoscopic surgery under insurance.

The diversification of surgical support robots has enabled medical institutions to select a system that suits their needs and budget. Accurate surgical field confirmation using 3D images and stable operation without shaking are basic features common to all systems, enabling minimally invasive surgery with minimal incisions.
Each system has its own unique features, such as the haptic feedback function of Saroa and Senhance, the modular design of Hugo, and the optimization of domestic systems such as hinotori and Saroa for the Japanese medical field. The emergence of domestic systems in particular allows for more efficient implementation and operation by enabling designs that are tailored to the characteristics and medical workflow of Japanese operating rooms.
However, these innovative technologies share the same challenges. The major challenges currently surgical support robots include high implementation and maintenance costs, the need for specialized training, and the space limitations of the operating room due to the size of the equipment.

In the United States, many medical institutions have already been proactively introducing surgical support robots, and the number of surgeries per year is steadily increasing. Their use is particularly prominent in prostate and gynecological surgeries. The diversification of options makes it possible for each medical institution to introduce the optimal system according to its scale and specialty. In Japan, robots are also being introduced, primarily at university hospitals, and the number of procedures is steadily increasing as insurance coverage expands.

The evolution of surgical support robots also opens up great possibilities for the realization of remote medical care. With the development of high-speed communication technology, research and demonstration experiments are underway to realize "remote surgery," in which specialists operate robots from physically distant locations to perform surgery. In June of this year, a demonstration experiment of remote surgery using 5G communication was successfully conducted by five parties: Kobe University, Docomo, NTT Com, Medicaroid, and Kobe City, demonstrating that it is technically possible for specialists in urban areas to remotely operate surgical support robots at regional hospitals to perform surgery. If remote surgery is put into practical use, it will be possible to provide advanced medical care beyond geographical constraints, and it is expected to improve access to specialized surgery in medically underserved areas. In addition, safer and higher quality medical care can be provided by having experienced doctors remotely support the surgery of junior doctors and obtain advice from specialists in emergencies.

When considering the role of surgical support robots, it is important to remember that they are merely "assistance" tools. The final decision and responsibility rests with the doctor, and the robot functions as a tool to complement the doctor's skills and achieve safer and more accurate surgery. The diversification of systems is expanding the possibilities for more flexible realization of this ideal collaborative relationship between doctors and robots.