Table 1.

Comparative analysis of alternative high-tech precision robotic systems [5–7]

Name	Features	Use	Approval	Advantages	Disadvantages
Open console robotic systems
Senhance system (Transenterix, Morrisville, NC, USA)	A 3D vision with glasses An infrared eye-tracking feature to control camera movement Up to 4 robotic arms on independent carts Feature of haptic feedback 5 and 3 mm mini-laparoscopic instruments	Abd. surgery, gynecology, urology	FDA and CE approval in 2017	Haptic feedback 3 mm mini-laparoscopic instruments Independent carts Easier intraoperative communication No need for system-specific trocars	Camera control with head movements (limits the surgeons comfort) 3D vision with glasses Handles similar to laparoscopic instruments 4 df range of movements similar to laparoscopy
Versius (CMR Surgical, Cambridge, GB)	A 3D vision with glasses Up to 5 robotic arms on independent carts 7 df range of movements 5 mini-laparoscopic instruments	Abd. surgery, gynecology, urology, thoracic surgery, ENT	Only CE approval in 2019	Independent carts Up to 5 arms Easier intraoperative communication No need for system-specific trocars	Camera control with head movements (limits the surgeons comfort) 3D vision with glasses Instruments handling is ergonomic compared to “clutch” function
Hugo RAS (Medtronic, Dublin, Ireland)	A 3D vision with glasses Up to 4 robotic arms on independent carts 7 df range of movements 5 mini-laparoscopic instruments	Not applicable	CE approval projected in 2021	Independent carts Easier intraoperative communication	Camera control with head movements (limits the surgeons comfort) 3D vision with glasses Instruments handling is ergonomic compared to “clutch” function
MiroSurge (German AeroSpace Center (DLR), Institute of robotics and mechatronics, Wessling, Germany)	Feature of haptic feedback A 3D vision with glasses 3 robotic arms on independent carts 7 df range of movements 5 mini-laparoscopic instruments	Not applicable	Not applicable	Independent carts Easier intraoperative communication Haptic feedback Instrument collision detection feature	Camera control with head movements (limits the surgeons comfort) 3D vision with glasses Instruments handling is ergonomic compared to “clutch” function
Flex surgical system (Medrobotics, Raynham, USA)	Flexible design of camera system operated with a simplified joystick Accompanied by 3 mm flexible instruments with articulating wrists	Colorectal, ENT	FDA and CE approval in 2019	Flexible camera Flexible 3 mm instruments	Designed for ENT and colorectal surgeries
Close console robotic systems
Revo-I (Meere Company, Hwasong, Korea)	Closed-console control unit 3D HD vision Robotic cart with 4 robotic arms 7 df range of movements 5 mm instruments Clutch function Training module	Abd. surgery, gynecology, urology	Korean FDA approval	Closed-console control unit “Clutch” function Training module	Obscured intraoperative communication Instrument clashing
Avatera (Avateramedical, Jena, Germany)	Closed-console control unit 3D HD vision Slender eyepiece design (surgeon’s mouth and ears remain uncovered) Robotic cart with 4 robotic arms 7 df range of movements 5 mm single-use instruments Use of only bipolar energy “Clutch” function	Abd. surgery, gynecology, urology	CE approval projected in 2021	Closed-console control unit Slender eyepiece design (surgeon’s mouth and ears remain uncovered) Single-use instruments Use of only bipolar energy Clutch function	Instrument clashing