Moving on from surgical robotics to robotic micro-tools in surgery

Over the past 20 years robotic systems have been deployed in surgery and have demonstrated benefits resulting in greater accuracy and consistency of tool trajectories when compared with comparable manual surgical interventions. It has been a great achievement to deploy such machines in the operating theatre environment in close proximity to patients and operating staff, and now commercial systems are available. Tool point guidance and cutting through the control of tool-point/tissue interaction is essential to increase precision further, particularly when working with soft or flexible tissues. The ability to automatically retrieve information describing tissues and the state of the process remains a challenging aspect. This paper focuses on the developing field of controlling tool-point interaction with tissues. The potential to discriminate different conditions and the means to use this information for control offers great potential towards the future of autonomous systems in surgery. This offers the order of magnitude greater accuracy needed in micro-surgical processes. The paper explores the challenges and novelty in formulating actuation, sensory and control solutions through discussion of some examples.