The Robot Will See You Now

Scalpels, Robots and the Operating Room of Tomorrow

A robot may perform part of your next surgery, and it may do some of the work without a human hand touching the controls. That sentence still sounds like the opening of a science-fiction movie—probably one where the hospital administrator dismisses several obvious warning signs before the second commercial break—but researchers have already trained a robot to identify, clip, and cut structures during a key portion of gallbladder surgery. The system successfully completed the sequence eight times, corrected some of its own mistakes, and never once paused to complain about the operating-room playlist.

That robot remains in a research laboratory. Inside actual hospitals, surgeon-controlled robotic systems are already assisting with prostate surgery, gallbladder removal, spinal procedures, heart-valve repair, cataract surgery, and the reconstruction of vessels thinner than a human hair. Artificial intelligence is beginning to watch operations as they happen, alerting surgical teams when instruments move outside the camera’s field of view and helping physicians navigate anatomy that can shift during a procedure.

Surgery has always depended on human judgment, experience, stamina, and extraordinarily steady hands. Robotic systems add magnified three-dimensional vision, tremor reduction, motion scaling, wristed instruments, real-time navigation, and an expanding layer of artificial intelligence. We are entering the early industrial phase of surgical medicine: the first reliable machines are working, useful products are coming off the line, and much of the factory is still being built. Fortunately, the factory dress code still appears to include scrubs instead of hard hats.

The New Machinery of Surgery

• Hugo RAS—urologic surgery. Medtronic’s Hugo system received FDA clearance in December 2025 for minimally invasive prostate, kidney, and bladder procedures. Its robotic arms sit on separate movable carts, allowing surgical teams to arrange the system around the patient and adapt it to different operating rooms. That flexibility matters because hospital floor space is apparently priced by the square inch, much like coastal California real estate.
• Touch Surgery Aide and Instrument Exit Point—AI watching the blind spots. Medtronic’s Instrument Exit Point application uses computer vision during Hugo procedures to alert the team when selected instruments move beyond the visible camera field. It is an early example of AI providing useful information during an operation, essentially functioning as a blind-spot warning for surgical instruments—with considerably more at stake than changing lanes on the freeway.
• OTTAVA—robotics built into the operating table. Johnson & Johnson received FDA authorization for OTTAVA in July 2026 for several abdominal procedures, including gastric bypass, sleeve gastrectomy, gallbladder removal, appendectomy, and hiatal-hernia repair. Its four robotic arms are integrated into the operating table, reducing the system’s footprint and allowing the table and arms to move together when the patient must be repositioned. Anyone who has moved a sofa through a narrow doorway can appreciate the value of having all the pieces cooperate.
• Versius Plus—bringing robotics into more hospitals. CMR Surgical’s Versius Plus received FDA clearance in late 2025 for gallbladder-removal procedures. Its compact, modular design can be moved between rooms and arranged around existing operating tables, potentially helping community hospitals and ambulatory surgery centers adopt robotics without rebuilding the entire surgical wing. Hospital administrators generally prefer technological revolutions that do not begin with a request for a new building.
• Symani—operating beyond the natural limits of the hand. Medical Microinstruments developed Symani for open microsurgery involving tiny blood vessels, lymphatic ducts, and nerves. The system scales down the surgeon’s movements and filters natural hand tremor while controlling instruments designed for structures as small as a fraction of a millimeter. An early feasibility study is now examining whether robotic microsurgery around deep cervical lymph nodes could improve the clearance of proteins associated with Alzheimer’s disease—an experimental idea that shows how robotics may help surgeons reach anatomy that was previously extraordinarily difficult to treat.
• Polaris—robotic assistance for cataract surgery. Horizon Surgical Systems reported the first human cataract procedure using its investigational Polaris platform in October 2025. The system combines microsurgical robotics, intelligent imaging, and AI-supported guidance in an effort to improve precision and reduce variability during one of the most frequently performed operations in the world. Polaris remains investigational, although most of us would prefer that anything operating inside the eye have both excellent precision and a very calm demeanor.
• Da Vinci 5 and Stealth AXiS—advancing heart and spine surgery. Intuitive Surgical’s da Vinci 5 received FDA clearance in January 2026 for selected cardiac procedures, allowing surgeons to work through small incisions between the ribs and avoid splitting the breastbone in appropriate cases. Medtronic’s Stealth AXiS combines surgical planning, navigation, and robotic guidance for spine procedures, including technology that tracks changes in spinal position during the operation. Both platforms generate growing amounts of surgical data that may eventually support more sophisticated AI guidance and training.
• SRT-H—the robot that completed surgical steps on its own. Researchers at Johns Hopkins trained the Surgical Robot Transformer-Hierarchy by showing it videos of surgeons performing gallbladder procedures. The robot then autonomously identified the cystic duct and artery, placed clips, cut the structures, and successfully completed the sequence on eight different ex-vivo pig gallbladders. It handled variations in anatomy, corrected errors during the procedure, and responded to spoken guidance, although humans still changed instruments and reloaded clips. Even surgical robots, apparently, have not escaped the need for technical support.
• STAR—autonomous suturing inside a living animal. An earlier Johns Hopkins system called the Smart Tissue Autonomous Robot performed intestinal anastomosis—the delicate process of reconnecting two ends of intestine—on live pigs under controlled conditions. A human operator selected among plans generated by the system, after which the robot executed much of the suturing independently. In measures such as spacing and consistency, the system performed as well as or better than conventional approaches, although it worked more slowly and remained under close supervision. It appears robots can also be meticulous coworkers who insist on doing everything carefully and take slightly longer than everyone hoped.

From Surgical Tool to Surgical Co-Pilot

No autonomous robot has performed a complete complex operation on a living human. Every robotic platform currently used in American hospitals remains under the direction of a trained surgeon, who controls the instruments and makes the clinical decisions. The research systems demonstrate something narrower and still enormously important: robots can learn defined surgical sequences, adapt to variations, and execute discrete tasks with limited intervention.

Progression may resemble the development of autonomous driving. Early systems warned drivers when they drifted from a lane. Later versions began controlling speed, braking, and steering under structured circumstances. Surgical robotics may follow a similar path, beginning with instrument alerts and anatomical overlays before gradually handling suturing, camera positioning, tissue retraction, and other well-defined portions of an operation. The surgeon would supervise the system, intervene when necessary, and concentrate on judgment, complications, and the unpredictable moments that refuse to fit neatly into a training dataset. Human anatomy, like assembling furniture, occasionally contains an unexpected part that does not appear in the instructions.

This connects directly with an idea I explored in “The Next Chapter of AI Is Robotics”: your robot may eventually live in the cloud. The arms, cameras, and surgical instruments are the physical hardware, while the longer-term value may reside in the intelligence layer that learns from thousands of procedures and carries those lessons across different machines. Such a system could eventually resemble an operating system for physical activity, improving through experience and distributing those improvements across an entire network. In the home, that intelligence might someday fold a fitted sheet. In the hospital, it could help a surgical system recognize an unusual situation because it has effectively observed something similar many times before. The hospital application will probably receive regulatory approval first.

As more companies enter the market, competition should improve the technology and place pressure on pricing, training, setup time, and hospital economics. Surgical systems must prove that they improve care while fitting into the reality of a busy operating room. A robot that performs beautifully during a demonstration and takes half a day to prepare may receive the same reaction as a teenager who volunteers to mow the lawn shortly after sunset.

The longer-term potential extends beyond making current operations more precise. Microsurgical robots may create treatment options by allowing physicians to work on structures that are too small, fragile, or deeply located for conventional techniques. AI could compare a live procedure with thousands of previous cases, identify unusual anatomy, anticipate complications, and offer guidance based on how similar patients responded. Greater autonomy for carefully defined tasks could reduce variability, shorten procedures, and help extend specialist expertise to hospitals and regions that cannot maintain every surgical subspecialty.

For investors, the opportunity spans robotic platforms, specialized instruments, imaging systems, sensors, semiconductors, high-performance computing, AI software, surgical training, and the hospitals and outpatient centers adopting these technologies. The eventual winners will need clinical evidence, dependable equipment, intuitive workflows, attractive economics, and responsible approaches to autonomy. Progress will be uneven, and enthusiasm will occasionally move faster than revenue. Wall Street has been known to declare a revolution fully complete shortly after discovering that a company has added “AI” to an investor presentation.

This article follows “The Next Medical Revolution Has Already Entered the Waiting Room,” where we explored how artificial intelligence is accelerating drug discovery, diagnosis, and clinical development. The revolution has now moved from the waiting room into the operating room, where AI and machines are beginning to influence the physical act of treatment itself.

The next installment will venture into an even stranger corner of medical technology: “Quantum Medicine: Designing the Drugs Today’s Computers Cannot See.” I will attempt to explain quantum computing without a chalkboard, advanced calculus, or a cat whose medical status is unnecessarily complicated.

As always, please call or email us if you would like to discuss how surgical robotics, real-time AI, and related medical technologies may intersect with your financial plan or how we are positioning portfolios around the companies enabling this transformation. The robots can operate with sub-millimeter precision, work without coffee breaks, and have yet to request reserved parking. They still cannot get three members of the same family to agree on where to have dinner, so human intelligence continues to serve an important purpose.

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