Robotics and Digital Surgery. Toward a Uniquely Differentiated Specialty.

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. This represents a powerful tool which will incrementally increase efficiency and accuracy, with the possibility of remote intervention. 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 movement. While we as vascular surgeons have embraced the power of imaging and image integration into our procedures and begun the exploration of endovascular robotics, 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.