Robotics and Digital Surgery. Toward a Uniquely Differentiated Specialty.

Abstract

Digital surgery is a composite term whereby computing power underpins the procedure and the operating environment. It includes advanced visualization, enhanced instrumentation, data capture, data analytics with artificial intelligence/machine learning, connectivity via telepresence, and robotic surgical platforms^{1, 2}. This represents a powerful tool which will incrementally increase efficiency and accuracy, with the possibility of remote intervention^{3, 4, 5}. Robotic surgery is the epitome of digital surgery including many of the elements described above. Every movement represents a mathematical formulation. All robotic movements can be recorded, reviewed, and used to train the next generation algorithms. Ultimately, there is the vision of autonomous, image guided robotic movement⁶. While we as vascular surgeons have embraced the power of imaging and image integration into our procedures and begun the exploration of endovascular robotics^7-11, other subspecialties have exploded in their use of surgical robots. In this address, I will present our re-evaluation of surgical robotics, discuss our fledgling efforts to incorporate endovascular skills and open techniques in parallel with a surgical robotic platform, and emphasize how we can create a uniquely differentiated vascular specialty.