Minimally invasive surgery (MIS) and the da Vinci system. As said, the need for robotic surgical systems is particularly linked with the emergence of minimally invasive surgery (MIS), giving important advantages over traditional laparoscopic procedures providing high degrees of dexterity in very constrained spaces inside the patient’s body. Manual laparoscopy is affected by several limitations and adverse effects, which can be summarized as follows: this technique only allows a two-dimensional (2D) vision from a conventional monitor, and that reduces the perception of depth; it permits just a scarce eye-hand coordination, decreasing the surgeon ergonomics and dexterity. Laparoscopic instruments demand a direct guidance, which requires ambidextrous manual activity; they are long and rigid, so that the surgeon’s natural hand tremor is amplified; these tools exclusively present five degrees of freedom: four for positioning the tip and one for actuation, and this aspect restricts the surgeon’s natural range of motion and decreases his dexterity. In the laparoscopic operations there are fixed abdominal entry points in the patient’s body, so the workspace reachable with the instrument’s tip is limited; instrument tip and handle move in opposite directions, giving origin to the technical drawback known as the fulcrum effect, which decreases the motor perception capability; the camera instability contributes to surgeon fatigue; the tactile feedback is limited, and it reduces the surgeon’s dexterity (Xxxxxxx et al., 2012). Laparoscopic and thoracoscopic surgery therefore impose significant ergonomic restrictions on the surgeon, increasing his difficulty in execution of major abdominal and thoracic operations. Moreover, the approach of the manual laparoscopy is uncomfortable for the surgeon, who has to maintain an awkward stance during the operation. Robot-assisted laparoscopic technology is directed to surmount these limitations. The most widely reported advantages of tele-operated robotic surgery stem from wristed instrument motions with seven degrees of freedom, scaling for precise movements, elimination of hand tremor, stereoscopic vision and improved ergonomics (Xxxxxxx et al., 2012). Another advantage is represented by the ability to eliminate innate handedness, proved by results obtained by surgeons performing tasks with both dominant and non-dominant hands (comparable performance with either hand) (Mucksavage, Kerbl & Xxx, 2011). A further advantage of surgical robots like the da Vinci consists in the high quality ...
