Background: Digitalization in surgery is gaining attention in the surgical community, with robotics and augmented reality as key issues.
Robotics: The term surgical robot is basically not adequate to describe currently available telesupport and manipulation systems. These are passive tools which have to be activated by the surgeon and only provide relatively low levels of active support. Accordingly, justification of use is currently difficult with respect to the cost-benefit relationship. A real breakthrough will be achieved by upgrading them into genuine intelligent and collaborative support systems and justify the term as the true meaning of robotics.
Augmented reality (ar): Augmented or enriched reality improves or facilitates normal sensory perception by the integration of additional information of a different nature. Intuitive perception of the surgical site would have the potential to revolutionize surgery, but prior to clinical use, the matching of the real and the virtual world still has to be optimized (referencing); however, AR is now already a valuable tool for training and simulation as well as workflow support in the operating room (OR).
Critical comment and perspectives: The promising new technological development towards the future cooperative surgical OR environment, including both robotic and AR modules, will have a significant impact on surgery, even in the mid-term. Decisive for this is that surgeons actively take part in the evaluation of this process to ensure that future "intelligent" tools will remain mere assistant or supporting systems.
Keywords: Artificial intelligence; Integrated operating room; Robotic camera control; Surgery 4.0; Telemanipulation system.