Why “first” is a matter of definition
No robot has a single, undisputed claim to being “the first to perform surgery”. The answer depends on what is meant. A robot might hold and position a tool, follow a surgeon’s hand movements, cut bone along a planned path, or act on its own judgment. Different machines did each of these at different times. Today’s surgical robots are almost always controlled or supervised by surgeons, and they are better understood as tools than as surgeons. This article covers history only.
The 1985 biopsy
The case most often cited as the first use of a robot in surgery took place in 1985. A team at Memorial Medical Center in Long Beach, California, led by Yik San Kwoh, used an industrial arm called PUMA 560 to hold a guide for a needle during a brain biopsy. A CT scan was used to plan the target, and the arm placed the guide at the planned angle. The robot did not cut anything by itself. It was positioned precisely, and the procedure used it as a steady and accurate holder. The use of computed tomography here reflected a wider move in which medical imaging and planning were becoming part of surgery.
This is a good example of how a milestone can be real and still a matter of definition. Supporters of the claim cite it as the first time a robot took an active part in a patient’s operation. Others point out that it was a positioning task rather than surgery in a broader sense.
Machines that cut bone and tissue
In Britain, a team at Imperial College London led by Brian Davies developed a robot for prostate surgery, and a device often called Probot was used on patients in the early 1990s to remove prostate tissue along a computed path. It is frequently listed as an early example of a robot performing part of a surgical procedure itself, in a limited and carefully controlled way.
In orthopedics, the system ROBODOC was developed from work in the late 1980s, and it was used on a human patient in a hip replacement around 1992. It milled the thigh bone to fit an implant according to a plan made from CT images. Because the robot actually carried out the cutting, ROBODOC is another candidate for the “first” label. It was, however, a planned, supervised machine, not a free decision-maker, and the technology was debated for years, with some studies raising concerns about complications and others finding benefits.
Robots that hold and assist
Another category is the robotic assistant. In the early 1990s, a company called Computer Motion developed AESOP, a voice-controlled arm that held an endoscope, the camera used in keyhole surgery, steadily for the surgeon. It received U.S. regulatory clearance in the mid-1990s and is often described as the first robotic system cleared for use in surgery. The same company later made a master-slave system called Zeus.
Telepresence surgery
The system that eventually became most widely used traces back to work on telepresence surgery at SRI International in the late 1980s and early 1990s, in part sponsored by the U.S. Army, which hoped to allow surgeons to operate on wounded soldiers from a distance. In that approach the surgeon sits at a console, looking at a three-dimensional image, and moves controls that guide small instruments inside the patient. The company Intuitive Surgical, formed in 1995, developed this into the da Vinci system, which was cleared for general laparoscopic surgery in the United States in 2000. Over the following years, it was adopted for operations such as prostate and gynecologic surgery, and later used in many other fields.
In 2001 a surgical team led by Jacques Marescaux used the Zeus system in New York to remove the gallbladder of a patient in Strasbourg, France, in what became known as the Lindbergh operation. It showed that remote surgery was technically feasible over a high-speed link, although such cases remain rare because of cost and the need for dependable networks.
What the robots do and do not do
Almost all modern surgical robots work under direct control of a surgeon, who decides what happens at each step. Advantages claimed for them include steadier instruments, better views and the ability to work through small incisions. Whether this leads to better outcomes than conventional laparoscopic or open surgery depends on the procedure, the surgeon’s experience and the cost considered, and studies have reached differing conclusions. For many operations the evidence is mixed. Researchers are exploring more automation for specific tasks, such as suturing, but fully autonomous surgery on people has not become routine practice.
So who was first?
A careful answer lists several firsts. The 1985 PUMA biopsy is commonly cited as the first robotic surgical procedure on a patient. Probot and ROBODOC are examples of robots carrying out part of an operation under a computer plan. AESOP was an early cleared assistant. The da Vinci became the best known. Which one counts as “the first robot that can perform surgery” depends on the definition, and honest histories describe the sequence rather than pick one name.