How robotic platforms have expanded the boundaries of minimally invasive surgery: a narrative review
摘要
Robotic surgery has evolved from a technological adjunct into a major platform for extending the reach of minimally invasive surgery (MIS). In contrast to conventional laparoscopy, robotic systems offer three-dimensional magnified visualization, wristed instrumentation, tremor filtration, improved ergonomics, and greater precision in narrow anatomical spaces. These features have supported wider adoption of technically demanding minimally invasive procedures that are difficult to reproduce consistently with straight-stick laparoscopy alone. This narrative review examines how robotic platforms have expanded MIS across urology, gynecology, colorectal surgery, thoracic surgery, and upper gastrointestinal surgery. Current evidence suggests that robotic surgery often reduces conversion to open surgery, blood loss, and length of hospital stay in complex procedures, although operative time is frequently longer and superiority over laparoscopy is not universal. The review also discusses the barriers that continue to limit broader expansion, including capital and maintenance costs, learning curves, absent or limited haptic feedback, unequal access, and heterogeneity in the evidence base. Finally, it considers emerging directions, including artificial intelligence, image guidance, robotic ultrasound integration, and haptic innovation. Robotic surgery should therefore be understood not as a wholesale replacement for laparoscopy, but as a selective enabler of advanced MIS when anatomical and technical constraints expose the limitations of conventional approaches.