What would be the next frontier in surgery? Surgery has relied on technological evolution to execute the surgical objective, perfect skills and quality of performance, and improve patient outcome. This has fostered innovative tools and techniques to enter the operating room (OR) for precise and accurate lesion localization imperative for safe target removal or implement other therapies. These include and are not restricted to the advent of macro- or micro-surgical tools, imaging modalities, image-guidance for planning and execution, modes of intra-operative monitoring, and more recently robotics. Robots and robot-assisted surgery have been used more as surgical adjunct, which is perhaps the safe approach given the level of preparation, execution or disruption in the OR workflow and cost associated with it. Can we envision a world where robotics and surgeons exist in a seamless and team-like symbiosis such that they not only enable or assist a surgeon, but also offer a level of expert reliance and thereby autonomy? If so, how?

While surgical robotics have been around for about five decades, and have certainly entered the operating rooms (OR), some even enjoying commercialization for wider acceptance and adoption than others, the idea, acceptance and acquisition of robotics at a more routine level continues to face resistance at multiple levels. Industry is still reluctant to create and offer an ideal robot that can efficiently aid in surgery as expertly and seamlessly as a well-trained surgeon or assistant. And many industries often revert to making a simpler robot or system, and not something that may disrupt the dynamics or human-machine interface and exchange in the OR. Why? Now that the world has made great advances in software/hardware/electronics/computing and analytics, including machine learning, i.e. Industry 4.0 disruption, can this perception and easy acceptance of robotics change?

It may be hypothesized that an all-encompassing robotic system with superb human-like senses, intelligence, dexterity, reaction time to name a few, is possible to create or achieve. Thus, by overcoming any perceived or real barrier/s to realizing such a surgical robotic system, an expert robot that ensures the safety and performance of surgery for improved patient care and surgeon guidance, will be a reality. Instead of raising hesitancy or intimidation amongst the surgical/OR team or buyers, robotics will be a necessity and an integral part of the ORs and hospitals worldwide.

The submission can be an original research work in the authors’ specific field of surgical robotics, a pre-clinical study, clinical trial or case study, a review or letter. While presenting the work, it is important to include aspects or features such as (but not restricted to):
• Current or future strategies on use of machine learning
• Smooth mechanical operations/computing capability
• Real time guidance and feedback for surgeon experience
• Learning
• Confidence
• Ease of use
• Surgical decision making
• Enhanced robot-assistance etc.
• Software intelligence of robotics, including use of large language models

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Frontiers in Robotics and AI

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