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October 28, 2020Annual Review of Control Robotics and Autonomous Systems251 citationsOpen Access

Autonomy in Surgical Robotics

AAAleks AttanasioBSBruno ScaglioniEMElena De Momi

Key Points

  • To examine the distinction between automatic and autonomous behaviors in surgical robotics and establish a taxonomy of autonomy levels alongside their enabling technologies.
  • Reviewed theoretical and clinical literature on autonomous and automatic systems in robotic surgery.
  • Categorized robotic capabilities into five progressive levels (Level 0 through Level 4) based on decision-making and execution independence.
  • Most current commercial surgical platforms operate at Level 0, characterized by absent decision autonomy.
  • Levels 1 and 2 provide cognitive/physical assistance and discrete autonomous surgical task performance, respectively.
  • Levels 3 and 4 introduce conditional autonomy with dynamic intraoperative replanning and the autonomous execution of multi-step surgical task sequences.

Abstract

This review examines the dichotomy between automatic and autonomous behaviors in surgical robots, maps the possible levels of autonomy of these robots, and describes the primary enabling technologies that are driving research in this field. It is organized in five main sections that cover increasing levels of autonomy. At level 0, where the bulk of commercial platforms are, the robot has no decision autonomy. At level 1, the robot can provide cognitive and physical assistance to the surgeon, while at level 2, it can autonomously perform a surgical task. Level 3 comes with conditional autonomy, enabling the robot to plan a task and update planning during execution. Finally, robots at level 4 can plan and execute a sequence of surgical tasks autonomously.

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Cite This Study

Attanasio et al. (2020) studied this question.

synapsesocial.com/papers/69dcb4edf729781886359242https://doi.org/10.1146/annurev-control-062420-090543
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