Co-Founder, XSurgical

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It’s been nearly two decades since robotic surgery using the da Vinci Surgical System has evolved as the standard technique for minimally invasive procedures in the U.S. and Europe — and with good reason. Precision, flexibility and control are all hallmarks of robot-assisted surgery, making it highly popular within the surgical suite. So, just imagine if that same robotic surgical application could be taken to the battlefield, the site of natural disasters or even space!

But, first back to earth. We’ve all seen the news footage; in war zones and times of natural disaster, the injured are typically triaged, then transported to treatment centers for surgery.  Those first few hours are critical and unfortunately, the wounded often receive a minimal level of care.

Currently, robotic surgical solutions aren’t feasible at the operational field owing to their bulky size and weight. Moreover, they require fixed installation and a sterile, controlled temperature environment, among other detracting elements, such as the inability to convert from laparoscopic to open surgery. Plus, they require surgeons to be on site, operating within feet of the injured. 

The good news is that advancements are now in process to bring surgical robotic solutions as close as the firing line, shortening the vital time lapse between wound and heal. The methodology — one that has received strong reviews from the military and the U.S. Department of Defense &mdash; would allow surgical robots to perform both minimally invasive and open surgery, guided by surgeons from remote locations. 

Without getting too technical, the remote methodology encompasses several surgical units: Each unit maintains a base with an anthropomorphous robotic arm, an end-effector mounted at the arm wrist carrying several actuators that drive the surgical tool and the surgical tool itself. 

The target weight of the units is limited to less than 300 pounds to enable parts to be deployed in the operational theater and to be deployable with normal military vehicles. Each surgical tool contains a distal component, a rod and an interface component.

The digital component is the actual surgical tool: i.e. grasper, scissors, dissector. It has two rotational joints in order to orient the tool’s tip around two perpendicular axes and to open and close its jaws.

This work in progress is being developed with artificial intelligence to make the technology fully autonomous in the next iterations. Because of its sensitivity, flexibility and size, it will be well suited to environments outside the surgical suite. Movement scaling is expected to exceed several times the accuracy of standard surgical robots; moreover, this new technology incorporates enhanced vision, navigation and high dexterity, making it reasonably easy to learn how to use and operate.

The advanced surgical robotics soon headed to market are modular in design for easy and swift set-up; make multi-quadrant procedures possible; can execute both laparoscopic and open procedures with microsurgery precision; contain sensors and software to simplify coordination of movements; and are compact and light enough for movement to another operating site within minutes.

Coming in at a cost expected to be of 50% less per procedure than the standard da Vinci method, the remote technology can perform five- to 10-times higher the number of procedures per tool and can be used in a wider variety of procedures than its competitors.

Changes in today’s battlefields and air space have made it challenging to evacuate patients to different locations for treatment. As such, surgical robotics technology holds great promise for expeditionary medical and theater hospital environments.

The benefits of deploying life-saving procedures to battlefield conditions, disaster recovery and eventually to space will make this in-development iteration of robotic surgery one for the ages.

This article was submitted by Gianluca De Novi, Ph.D., CEO and co-founder of XSurgical.  For more information visit 

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