Table 1.
Surgical robots in clinical use.
| Robot | Parent company | FDA approved | Organ system/operations | Features | Drawbacks | References |
|---|---|---|---|---|---|---|
| Surgical robots | ||||||
| da Vinci platforms:X and Xi | Intuitive Surgical (USA) | 2000 | Robot-assisted MIS in various organ systemsa | 6 DoF robotic arms with numerous attachable surgical instrumentsX,Xi: 3 surgical arms, 1 camera arm | Steep learning curveHigh capital costsAccessibility gap | Company website 46 Crew 18 George et al. 47 |
| NeuroMate | Integrated Surgical Systems (USA) acquired by Renishaw (UK) | 1999 | Brain biopsy, DBS, SEEG, neuroendoscopy, radiosurgery | 5 DoF robotic arm with CT or MRI guidance | High costs | Li et al. 23 |
| ROSA® ONE Brain and Spine | Medtech Montpellier (France) Acquired by Zimmer Biomet (USA) | 2018, 2019 | Brain biopsy, DBS, SEEG, ventricular endoscopy, spinal surgery | Image-based preoperative planning and intraoperative CT for bone resection or needle trajectoryFrame-based and frameless stereotactic neurosurgery | Increased surgical timesHigh costsProne to error if patient motion disrupts image reference for robot | Lefranc et al. 24 Paff et al. 25 Chenin et al. 48 |
| Auto Stealth Guide Mazor XRenaissanceSpineAssist | Mazor Robotics (Israel)Acquired by Medtronic (USA) | 2016 | Neurosurgery, spinal surgery | First approved spinal robot; remains most widely used3D preoperative CT planning for screw location/size in spinal surgery | Screw misplacement secondary to tool skiving Prone to improper image registration | D’Souza et al. 49 Khan et al. 50 |
| SYMBISFormerly NeuroArm | IMRIS (Canada) | 2015 | MRI-guided neurosurgical brain tumor resection | 7 + 1 DoF robot with piezoelectric actuationMR conditional robot allowing use in intraoperative MRI suites | High costsUsed only for brain tumors | Sutherland et al. 51 |
| NeuroBlate | Monteris Medical (USA) | 2018 | MRI-guided intracranial laser ablation | 2 DoF cranial robot with remote workstationMR thermometry monitors ablation quasi real-time | Risk of overheating, tissue damage | Sloan 52 |
| Excelsius GPS | Globus Medical (USA) | 2018 | Spinal surgery | 6 DoF robotic arm, first with haptic feedback | Limited data on long-term outcomes | Vardiman 53 |
| Endovascular interventions | ||||||
| CorPath GRXCorPath 200 | Corindus Vascular Robotics (USA)Acquired by Siemens Healthineers (USA) | PCI: 2012 PVI: 2018NVI: CE mark 2018 | PCI, PVI, and NVI | Single-use robotic cassette compatible many endovascular devicescLong distance tele-operated interventions 39 Smart features for endovascular navigation | May be limited by network performance and traffic | Patel et al. 15 , 54 Mahmud et al. 38 Mendes Pereira et al. 43 |
| MagellanSensei X | Hansen Medical (USA)Acquired by Auris Surgical Robotics (USA) | 2012b2009b | Peripheral arterial diseaseEP mappingCardiac ablationAneurysm repair | Electromechanical steerable pull-wire catheter system Remote operator workspace with joystick master-slaveCF sensing feedback technology | FDA approved only for specialized cathetersHuman–robot interface not intuitive Limited widespread adoption due to costs and company acquisition | Bismuth et al. 55 Cochennec et al. 56 Saliba et al. 57 Dello Russo et al. 58 |
| Amigo | Catheter Robotics (USA) | 2012 | EP mappingCardiac ablation | Electromechanical remote steerable catheterIntuitive command interface | Cumbersome design for EP catheterization lab No CF sensing feedback requiring special catheters | Khan et al. 59 Datino et al. 60 Hoffmayer et al. 61 |
| Genesis Niobe ES | Stereotaxis (USA) | Genesis: 2020Niobe: 2013 | EP mappingCardiac ablation | Robotic magnetic navigation of catheter steered with two computer-controlled magnets on each side of patientGenesis is smaller and faster than its Niobe ES predecessor | Requires specialized EP cathetersNiobe encumbered setup No CF sensing technology | Yuan et al. 31 Turagam et al. 62 |
| R-One™ | Robocath (France) | CE Mark 2019 | PCIInvestigating PVI and NVI | Robotic arm with device cassette adaptable to many endovascular devicesMobile radio-protected control station with joystick and interface | Limited clinical evidence | Salimi et al. 63 Cardiovascular News 64 |
| XCath | XCath, Inc. (USA) | N/A | NVI | Robotically controlled steerable smart guidewireHaptic feedback and soft atraumatic tip | Limited clinical evidence | Company website 65 |
aMinimally invasive cardiac, colorectal, gynecologic, head and neck, thoracic, urologic, and general surgeries.
bNo longer commercially available.
c0.014-inch guidewires, rapid-exchange coronary angioplasty balloons, and stent delivery systems.
MIS: minimally invasive surgery; DoF: degrees of freedom; FDA: Food and Drug Administration; CE: Conformité Européene; CT: computed tomography; MRI: magnetic resonance imaging; DBS: deep brain stimulation; SEEG: stereoelectroencephalography; PCI: percutaneous coronary intervention; PVI: peripheral vascular intervention; NVI: neurovascular intervention; EP: electrophysiology; CF: contact force; RMN: robotic magnetic navigation; N/A: not applicable.