Autonomy for Surgical Robots: Concepts and Paradigms

Robot-assisted and computer-integrated surgery provides innovative, minimally invasive solutions to heal complex injuries and diseases. The dominant portion of these surgical interventions has been performed with master-slave teleoperation systems, which are not capable of autonomous task execution or cognitive decision making. Much of the most advanced technologies foundered on the drawing boards or at the research labs for a long time, partially due to the fact that the surgical domain is resistant to the introduction of new hazards via the increased complexity of novel solutions. It has been seen with similar heavily regulated areas that internationally accepted standards can facilitate the adoption of new technologies in a safe manner. This paper reviews the existing autonomous capabilities of surgical robots, and investigates the major barriers of development presented by the lack of autonomy benchmarks and standards. The emerging safety standard environment is presented, as a key enabling factor to the commercialization of autonomous surgical robots. A practical scale is introduced to assess the level of autonomy of current and future surgical robots. Regarding the forthcoming robotic platforms, it is crucial to improve the transparency of the regulatory environment, streamline the standardization framework, and increase the social acceptance.