Table 3.
Robotic surgical systems for visualization in natural orifice procedures, by year
| Name | Visualization type | DOF | Manipulation type | Actuation method | Control type & level of automation | Control interface | Development stage | Year | Clinical application | |
|---|---|---|---|---|---|---|---|---|---|---|
| Camera | Total | |||||||||
| Flex system (Medrobotics Corp., USA) [29, 68, 69] |
3D HD Dual 1920 × 1080 pixel 80° field of view |
– | – | 180° articulation, horizontal, vertical, rotation, zoom | Cable-driven |
Teleoperated Master–slave |
Open console Single-port control joystick |
Commercial | 2015 (FDA) |
Surgery—minimally invasive Transoral surgery (oropharyngeal, hypopharyngeal, laryngeal procedures) Obstetric/gynecologic applications |
| MONARCH platform (Auris Health, Inc., USA)a [14, 70–73] | 660p x central airways & periphery vision | 10 | – |
Insertion, retraction, articulation 180° in all direction |
Cable-driven |
Teleoperated Master–slave |
Hand-held controller (joysticks & buttons) | Commercial | 2018 (FDA) |
Investigational procedure Robotic bronchoscopy for peripheral pulmonary lesion biopsy Surgery—minimally invasive Urology—percutaneous nephrolithotomy |
| STRAS (ICubeb) [13, 16] | – | 2 | 10 | Rotation, deflection, translation | Motor (tendon-driven) |
Teleoperated Master–slave |
Handle shaft on L-shaped bracket, two small four-way finger joysticks to operate endoscope | Research prototype (animal studies) | 2018 |
Surgery—minimally invasive Treatment of tumor in rectum and sigmoid colon Gastrointestinal tract surgery Endoscopic submucosal dissection (ESD) in animal model |
| i2Snake (Hamlyn Centre, UK) [74] |
3 mm 640 × 480 pixels |
– | 7 | – | Tendon driven actuated by EC motors |
Teleoperated Master–slave |
Hand-held gripper Foot pedal for switching modes |
Research prototype (lab studies) | 2018 |
Surgery—minimally invasive Transoral surgery Tumor resection, sleep-apnea surgery |
| Ion endoluminal system (Intuitive Surgical Inc., USA) [75–77] |
Removable vision probe 90° field of view 0° direction of view |
– | – |
180° in all direction (pitch & yaw) |
Electromechanically (servo/stepper motors & software) |
Teleoperated Master–slave |
Hand control (trackball & scroll wheel) | Commercial | 2019 (FDA) |
Investigational procedure Minimally invasive peripheral lung biopsy (bronchoscopy) |
| Endoscopic Therapeutic Robot System (ETRS) (Kyushu Institute of Technology, Japan)c [78] | 120° field of view | 4 | – | Up/down & left/right angulation, insertion/retraction, rotation | Motor |
Teleoperated Master–slave |
Hand controls (Geomagic Touch) | Research prototype (animal studies) | 2019 |
Surgery—minimally invasive Endoscopic submucosal dissection (ESD) in porcine model |
| K-FLEX (EasyEndo Surgical, Korea) [79] | High definition | 4 | 14 | Deflection, translation, rotation | Wire cable & motor |
Teleoperated Master–slave |
Hand interface switched by foot clutch | Research prototype (ex vivo porcine study) | 2020 |
Surgery—minimally invasive Possible application for gastrointestinal tract, ENT surgeries |
| Three-Limb Robotic System (Nanyang Technological University, Singapore)d [16, 80, 81] |
120° field of view 0° forward viewing |
4 | 13 | Up/down, left/right, in/out, rotation | Tendon-sheath mechanism & motors |
Teleoperated Master–slave |
Open master console Two hand interfaces One foot interface to control endoscope |
Research prototype (ex vivo porcine study) | 2021 |
Surgery—minimally invasive Transoral robotic surgery Gastrointestinal tract surgery Endoscopic resection |
| Endoluminal Surgical System (EndoQuest Robotics, USA)e [82, 83] | 3.7 mm HD robotic camera | – | 7 | Advanced flexibility & dexterity | – |
Teleoperated Master–slave |
Open surgeon console—hand controllers & foot pedal (clutch) | Research prototype (clinical trial) | 2021 |
Surgery—minimally invasive Transanal endoluminal procedures; colorectal endoscopic submucosal dissection (ESD) |
aAuris Health previously acquired Hansen Medical, manufacturer of Magellan & Sensei robotic systems. Auris Health was later acquired by Johnson & Johnson, which plans to build Ottava.
bSTRAS is a robotic version of Anubiscope (IRCAD & KARL STORZ Endoskope)
cThe endoscope is controlled by endoscopic operation robot (EOR)
dNanyang Technological University has also produced the robotic system EndoMaster (EndoMaster Pte Ltd., Singapore). However, it requires manual operation of the endoscope
eEndoluminal Surgical System was previously known as ColubrisMX ELS System