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Medical robotics 167

(Kwoh et al., 1988). This has served as the prototype for neuromate
(Integrated Surgical Systems, Sacramento, CA, USA), which received
FDA approval in 1999. Thus, in spite of the encouraging preliminary results,
the work on the PUMA robot was ceased. In 1991, Imperial College in
London developed a small-sized robot called the ProBot. This later was used
to perform a prostatic surgery. In 1992, the Robodoc (Integrated Surgical
Systems) was introduced for use in hip replacement surgery. In 1996, similar
devices were designed for use in knee replacement and temporal bone sur-
gery, notably the Acrobot (The Acrobot Company, Ltd., London, UK) and
the RX-130 robot (Staubli Unimation Inc., Faverges, France), respectively.
Neither device has yet completed clinical testing nor received FDA approval.
Since then, surgical robotics was deeply marked by MIS. MIS involves
the use of long rigid or flexible surgical instruments that are inserted into the
body through small incisions or natural orifices, in contrast to open surgery
where large incisions are used to access the target organ directly. The goal of
MIS is to complete a surgical procedure as safely and quickly as possible,
while minimizing damage to peripheral tissue. MIS is being used with
increasing frequency as an alternative to open surgery because of the
improvements it can bring to patient safety, cosmetics, recovery time, hos-
pital stays, postoperative complications, and pain. The development of a
tele-operated surgical robot is motivated by the desire to enhance the effec-
tiveness of the surgical procedure and provide a comfortable operating envi-
ronment for the surgeon. In this framework, Automated Endoscopic System
for Optimal Positioning (AESOP), produced by Computer Motion Com-
pany and initially funded by NASA, was introduced in 1994 as the first lap-
aroscopic camera holder to be approved by the FDA. Voice control was then
added in 1996 for position control of the camera. Seven degrees of freedom
were added in 1998 to mimic a human hand. The endoscope can be inserted
into the patient through a smaller incision.
In 1998, ZEUS was introduced commercially by the American robotics
company Computer Motion with the original idea of telepresence surgery.
For such a system, the surgeon operates on the patient at a distance from a
robot console. ZEUS’s major success was in cardiac surgery. ZEUS had
three robotic arms remotely controlled by the surgeon. The first arm,
AESOP, the voice-activated endoscope, allowed the surgeon to see inside
the patient’s body. The other two robotic arms mimicked the surgeon’s
movements to make precise incisions and extractions.
In 1999, several projects on robotic tele-ecography were launched
(Gonzales et al., 2001). Such robotic systems, like the SYRTECH system