Robotics: The next step?
Robotic systems were introduced 15 years ago to support complex endoscopic procedures. The technology is increasingly used in gastro-intestinal surgery. In this article, literature on experimental- and clinical research is reviewed and ergonomic issues are discussed.


METHODS
literature review was based on Medline search using a large variety of search terms, including e.g. robot(ic), randomized, rectal, oesophageal, ergonomics. Review articles on relevant topics are discussed with preference.


RESULTS
There is abundant evidence of supremacy in performing complex endoscopic surgery tasks when using the robot in an experimental setting. There is little high-level evidence so far on translation of these merits to clinical practice.


CONCLUSIONS
Robotic systems may appear helpful in complex gastro-intestinal surgery. Moreover, dedicated computer based technology integrated in telepresence systems opens the way to integration of planning, diagnostics and therapy. The first high tech add-ons such as near infrared technology are under clinical evaluation.
Department of Surgery, Meander Medical Centre, Utrechtseweg 160, 3818 ES Amersfoort, The Netherlands; Twente University, Technical Medicine, Carre Building CR 3629, Drienerlolaan 5, 7522 NB Enschede, The Netherlands. Electronic address: Iamj.broeders@meandermc.nl.
Ivo A M J
IA
Broeders
D000818:Animals; D002983:Clinical Competence; D004059:Diffusion of Innovation; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006804:Ergonomics; D006801:Humans; D059032:Learning Curve; D009048:Motor Skills; D012371:Robotics / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation; D016896:Treatment Outcome
Endoscopic; Robotic; Surgery; da Vinci