The Future of Telerobotic Surgery

  • Garth H. Ballantyne


The confluence of minimally invasive surgery, integrated operating rooms, and telerobotic surgery promises substantial advances for all types of surgery in the 21st century. Laparoscopic approaches to minimally invasive surgery have won dramatic gains for patients in terms of short-term outcomes. Integrated laparoscopic operating rooms insert teleconferencing capabilities into surgical suites and offer easy access to telementoring for inexperienced surgeons during the steep learning curves of many advanced minimally invasive surgical procedures. The rapid evolution of robot-assisted surgery into telerobotic surgery provides technologic solutions to many of the inherent limitations of laparoscopic surgery. Moreover, the surgeon’s console of telerobotic surgical systems provides a platform for integration in novel formats of the varied forms of digital information currently generated for surgical patients.


Laparoscopic Cholecystectomy Virtual Reality Augmented Reality Surgical Training Surgical Simulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ballantyne GH. Granting clinical privileges for telerobotic surgery. Surg Laparosc Endosc Percut Tech 2002;12:17–25.CrossRefGoogle Scholar
  2. 2.
    Doarn CR. Telemedicine in tomorrow’s operating room: a natural fit. Semin Laparosc Surg 2003;10: 121–126.PubMedGoogle Scholar
  3. 3.
    Rosser JC, Wood M, Payne JH, et al. Telementoring. A practical option in surgical training. Surg Endosc 1997;11:852–855.PubMedCrossRefGoogle Scholar
  4. 4.
    Lee BR, Bishoff JT, Janetschek G, et al. A novel method of surgical instruction: international telementoring. World J Urol 1998;16:367–370.PubMedCrossRefGoogle Scholar
  5. 5.
    Lee BR, Caddedu JA, Janetschek G, et al. International surgical telementoring: our initial experience. Stud Health Technol Inform 1998;50: 41–47.PubMedGoogle Scholar
  6. 6.
    Cubano M, Poulose BK, Talamini MA, et al. Long distance telementoring. A novel tool for laparoscopy aboard the USS Abraham Lincoln. Surg Endosc 1999;13:673–678.PubMedCrossRefGoogle Scholar
  7. 7.
    Byrne JP, Mughal MM. Telementoring as an adjunct to training and competence-based assessment in laparoscopic cholecystectomy. Surg Endosc 2000;14:1159–1161.PubMedCrossRefGoogle Scholar
  8. 8.
    Bruschi M, Micali S, Porpiglia F, et al. Laparoscopic telementored adrenalectomy: the Italian experience. Surg Endosc 2005;19:836–840.PubMedCrossRefGoogle Scholar
  9. 9.
    Schneider A, Wilhelm D, Bohn U, et al. An evaluation of a surgical telepresence system for an intrahospital local area network. J Telemed Telecare 2005;11:408–413.PubMedCrossRefGoogle Scholar
  10. 10.
    Mullaney TJ, Weintraub A. The digital hospital: how info tech saves lives and money at one medical center. Is this the future of health care? Business Week: 2005:77–84.Google Scholar
  11. 11.
    Ellison LM, Pinto PA, Kim F, et al. Telerounding and patient satisfaction after surgery. J Am Coll Surg 2004;199:523–530.PubMedCrossRefGoogle Scholar
  12. 12.
    Smith CD, Skandalakis JE. Remote presence proctoring by using a wireless remote-control videoconferencing system. Surg Innov2005;12:139–143.PubMedCrossRefGoogle Scholar
  13. 13.
    Satava RM, Simon IB. Teleoperation, telerobotics, and telepresence in Surgery. Endosc Surg 1993;1: 151–153.Google Scholar
  14. 14.
    Green PE, Piantanida TA, Hill JW, et al. Telepresence: dexterous procedures in a virtual operating field [abstract]. Am Surg 1991;57:192.Google Scholar
  15. 15.
    Jensen JF, Hill JW. Advanced telepresence surgery system development. Stud Health Technol Inform 1996;29:107–117.PubMedGoogle Scholar
  16. 16.
    Satava RM. Virtual reality and telerpresence for military medicine. Ann Acad Med Singapore 1997;26:118–120.PubMedGoogle Scholar
  17. 17.
    Satava RM. Surgical robotics: the early chronicles: a personal historical perspective. Surg Laparosc Endosc Percut Tech 2002;12:6–16.CrossRefGoogle Scholar
  18. 18.
    Satava RM. Robotic surgery: from past to future —a personal journey. Surg Clin North Am 2003;83:1491–1500.PubMedCrossRefGoogle Scholar
  19. 19.
    Bowersox JC, Cordts PR, LaPorta AJ. Use of an intuitive telemanipulator system for remote trauma surgery: an experimental study. J Am Coll Surg 1998;186:615–621.PubMedCrossRefGoogle Scholar
  20. 20.
    Ewing DR, Pigazzi A, Wang Y, Ballantyne GH. Robots in the operating room — the history. Semin Laparosc Surg 2004;11:63–71.PubMedGoogle Scholar
  21. 21.
    Ballantyne GH, Moll F. The da Vinci telerobotic surgical system: the virtual operative field and telepresence surgery. Surg Clin North Am 2003;83:1293–1304.PubMedCrossRefGoogle Scholar
  22. 22.
    Marescaux J, Leroy J, Gagner M, et al. Transatlantic robot-assisted telesurgery. Nature 2001;413: 379–380.PubMedCrossRefGoogle Scholar
  23. 23.
    Marescaux J, Leroy J, Rubino F, et al. Transcontinental robot-assisted remote telesurgery: feasibility and potential applications. Ann Surg 2002;235: 487–492.PubMedCrossRefGoogle Scholar
  24. 24.
    Larkin M. Transatlantic, robot-assisted telesurgery deemed a success. Lancet 2001;358:1074.PubMedCrossRefGoogle Scholar
  25. 25.
    Anvari M. Robot-assisted remote telepresence surgery. Semin Laparosc Surg 2004;11:123–128.PubMedGoogle Scholar
  26. 26.
    Sebajang H, Trudeau P, Dougall A, et al. Telementoring: an important enabling tool for the community surgeon. Surg Innov 2005;12:327–331.PubMedCrossRefGoogle Scholar
  27. 27.
    Anvari M, McKinley C, Stein H. Establishment of the world’s first telerobotic remote surgical service: for provision of advanced laparoscopic surgery in a rural community. Ann Surg 2005;241: 460–464.PubMedCrossRefGoogle Scholar
  28. 28.
    Satava RM. Transitioning to the furure. J Am Coll Surg 1998;186:691–692.PubMedCrossRefGoogle Scholar
  29. 29.
    Satava RM. Telepresence for the laparoscopic surgeon. In: Zucker KA, ed. Surgical Laparoscopy. New York: Lippincott Williams & Wilkins; 2001: 797–802.Google Scholar
  30. 30.
    Herron DM, Gagner M, Kenyon TL, Swanstrom LL. The minimally invasive surgical suite enters the 21st century. A discussion of critical design elements. Surg Endosc 2001;15:415–422.CrossRefGoogle Scholar
  31. 31.
    Seales WB, Caban J. Visualization trends: applications in the operating room. Semin Laparosc Surg 2003;10:107–114.PubMedGoogle Scholar
  32. 32.
    Satava RM. The operating room of the future: observations and commentary. Semin Laparosc Surg 2003;10:99–105.PubMedGoogle Scholar
  33. 33.
    Satava RM. Disruptive visions: a robot is not a machine…systems integration for surgeons. Surg Endosc 2004;18:617–620.PubMedCrossRefGoogle Scholar
  34. 34.
    Marescaux J, Soler L. Image-guided robotic surgery. Semin Laparosc Surg 2004;11:113–122.PubMedGoogle Scholar
  35. 35.
    Marescaux J, Mutter D, Soler L, et al. [The Virtual University applied to telesurgery: from tele-education to tele-manipulation]. Bull Acad Natl Med 1999;183:509–521.PubMedGoogle Scholar
  36. 36.
    Marescaux J, Soler L, Mutter D, et al. Virtual university applied to telesurgery: from teleeducation to telemanipulation. Stud Health Technol Inform 2000;70:195–201.PubMedGoogle Scholar
  37. 37.
    Soler L, Delingette H, Malandain G, et al. An automatic virtual patient reconstruction from CTscans for hepatic surgical planning. Stud Health Technol Inform 2000;70:316–322.PubMedGoogle Scholar
  38. 38.
    Mutter D, Bouras G, Marescaux J. Digital technologies and quality improvement in cancer surgery. Eur J Surg Oncol 2005;31:689–694.PubMedCrossRefGoogle Scholar
  39. 39.
    Muller W, Grosskopf S, Hildebrand A, et al. Virtual reality in the operating room of the future. Stud Health Technol Inform 1997;39:224–231.PubMedGoogle Scholar
  40. 40.
    Marescaux J, Rubino F, Arenas M, et al. Augmented-reality-assisted laparoscopic adrenalectomy. JAMA 2004;292:2214–2215.PubMedCrossRefGoogle Scholar
  41. 41.
    Le Mer P, Soler L, Pavy D, et al. Argonaute 3D: a real-time cooperative medical planning software on DSL network. Stud Health Technol Inform 2004;98:203–209.Google Scholar
  42. 42.
    Satava RM. Virtual reality surgical simulator. The first steps. Surg Endosc 1993;7:203–205.PubMedCrossRefGoogle Scholar
  43. 43.
    Coleman J, Nduka CC, Darzi A. Virtual reality and laparoscopic surgery. Br J Surg 1994;81: 1709–1711.PubMedCrossRefGoogle Scholar
  44. 44.
    Marescaux J, Clement JM, Tassetti V, et al. Virtual reality applied to hepatic surgery simulation: the next revolution. Ann Surg 1998;228:627–634.PubMedCrossRefGoogle Scholar
  45. 45.
    Krummel TM. Surgical simulation and virtual reality: the coming revolution. Ann Surg 1998;228: 635–637.PubMedCrossRefGoogle Scholar
  46. 46.
    O’Toole RV, Playter RR, Krummel TM, et al. Measuring and developing suturing technique with a virtual reality surgical simulator. J Am Coll Surg 1999;189:114–127.PubMedCrossRefGoogle Scholar
  47. 47.
    Gorman PJ, Meier AH, Krummel TM. Simulation and virtual reality in surgical education: real or unreal? Arch Surg 1999;134:1203–1208.PubMedCrossRefGoogle Scholar
  48. 48.
    Chaudhry A, Sutton C, Wood J, et al. Learning rate for laparoscopic surgical skills on MIST VR, a virtual reality simulator: quality of human-computer interface. Ann R Coll Surg Engl 1999;81:281–286.PubMedGoogle Scholar
  49. 49.
    Satava RM. Accomplishments and challenges of surgical simulation. Surg Endosc 2001;15:232–234.PubMedCrossRefGoogle Scholar
  50. 50.
    Bansal VK, White AP. Virtual systems for simulated surgical resident training. In: Ballantyne GH, Marescaux J, Giulianotti PC, eds. Primer of Robotic & Telerobotic Surgery. New York: Lippincott Williams & Wilkins; 2004:237–242.Google Scholar
  51. 51.
    Sweet R, Porter J, Oppenheimer P, et al. Simulation of bleeding in endoscopic procedures using virtual reality. J Endourol 2002;16:451–455.PubMedCrossRefGoogle Scholar
  52. 52.
    Sweet R, Kowalewski T, Oppenheimer P, et al. Face, content and construct validity of the University of Washington virtual reality transurethral prostate resection trainer. J Urol 2004;172:1953–1957.PubMedCrossRefGoogle Scholar
  53. 53.
    Kallstrom R, Hjertberg H, Kjolhede H, Svanvik J. Use of a virtual reality, real-time, simulation model for the training of urologists in transurethral resection of the prostate. Scand J Urol Nephrol 2005;39:313–320.PubMedCrossRefGoogle Scholar
  54. 54.
    Johnson DB, Kondraske GV, Wilhelm DM, et al. Assessment of basic human performance resources predicts the performance of virtual ureterorenoscopy. J Urol 2004;171:80–84.PubMedCrossRefGoogle Scholar
  55. 55.
    Jacomides L, Ogan K, Cadeddu JA, Pearle MS. Use of a virtual reality simulator for ureteroscopy training. J Urol 2004;171:320–323.PubMedCrossRefGoogle Scholar
  56. 56.
    Ogan K, Jacomides L, Shulman MJ, et al. Virtual ureteroscopy predicts ureteroscopic proficiency of medical students on a cadaver. J Urol 2004;172: 667–671.PubMedCrossRefGoogle Scholar
  57. 57.
    Knoll T, Trojan L, Haecker A, et al. Validation of computer-based training in ureterorenoscopy. BJU Int 2005;95:1276–1279.PubMedCrossRefGoogle Scholar
  58. 58.
    Torkington J, Smith SG, Rees BI, Darzi A. The role of simulation in surgical training. Ann R Coll Surg Engl 2000;82:88–94.PubMedGoogle Scholar
  59. 59.
    Gallagher AG, Ritter EM, Champion H, et al. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 2005;241: 364–372.PubMedCrossRefGoogle Scholar
  60. 60.
    Schijven MP, Jakimowicz JJ, Broeders IA, Tseng LN. The Eindhoven laparoscopic cholecystectomy training course —improving operating room performance using virtual reality training: results from the first E.A.E.S. accredited virtual reality trainings curriculum. Surg Endosc 2005;19: 1220–1226.PubMedCrossRefGoogle Scholar
  61. 61.
    Aggarwal R, Grantcharov T, Moorthy K, et al. A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill. Am J Surg 2006;191: 128–133.PubMedCrossRefGoogle Scholar
  62. 62.
    Aggarwal R, Darzi A. Training in laparoscopy — which model to use? Indian J Gastroenterol 2005; 24:95–96.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2007

Authors and Affiliations

  • Garth H. Ballantyne
    • 1
  1. 1.Department of SurgeryHackensack University Medical CentreHackensackUSA

Personalised recommendations