Safety for active endoscopy

In the last decade there has been considerable activity in the new area of applying robotic technology within the operating theatre. In the most general terms surgeons are considering advanced positioning and manipulation devices because they offer increases in alignment and positional accuracy, spatial coordination, stability and repeatability. This technology gives opportunities to consider more minimally invasive surgical techniques and may reduce the complication rates of current procedures. However, attempting to develop these advanced tools reinforces the centrality of the surgeon. The surgeon´s skills of decision making based on past knowledge and real-time sensory feedback, coupled with the dexterity of the surgeon´s hands, are essential for surgery within the complex and variable environment that is our body. This paper considers a number of current research projects, identifying the stance taken in terms of safety. In particular, the issues of intrinsically safe designs, and the role of passive and active mechanisms. It then focuses on the particularly difficult and futuristic task of using computer controlled redundant endoscopes to reach locations in the body in a minimally invasive manner