## 2 Robotic Requirements in MIS  
Although hand-held robots are commercially available, the standard instrument for MIS is a traditional hand-held laparoscopic device, characterised by its end effector, of which there are several types. The most commonly used ones are graspers, with curved jaws or fenestrated plates, needle holders, scissors, or, more recently, thanks to advances in laser technology, contactless laser-based dissectors. Irrespective of the type of end effector, the standard instrument's tip has limited operating flexibility and often only possesses opening and closing options. Increased dexterity would, among other things, constitute a major step forward and, to this end, we have distilled the key characteristics that such an instrument would require, based on background research and clinicians' perceptions:  
1. Accurate positioning of the end effector tool at the target point (operating site). This is key to all precision surgery, not least of all extended lymphatic dissection, which increasingly appears to be improving the overall survival of cancer patients [12; 13; 14];
2. Increased dexterity. There is a clear need for instruments to have enhanced dexterity in order to reach further into a patient's abdomen, pelvic and other more obscure areas, while at the same time being able to circumvent organs and other \"obstacles\". It is therefore not simply the end effector that needs greater flexibility and manoeuvrability, but the entire robot arm itself [3; 15];
3. Intuitive operation and control of the robot. When MIS was introduced into the clinical setting, surgeons, to an extent, had to reinvent themselves. They were now working without the direct 3D vision they had grown accustomed to, nor indeed without the ability to directly manipulate objects (tissue, organs, etc.) with their hands. Ever since then, efforts have been made to restore the intuitive nature of surgical activity, through more advanced tools and technologies. That intuitiveness would need to be retained as new soft robotic systems are developed;
4. Feedback on the interaction forces for any point of contact between the robot and patient. The lack of force feedback remains one of the principal limitations of current devices, as there is little way to mitigate the risk of impact and friction between the device and tissue or organs around it [16; 17; 18; 19]. It is noted that this is a particular issue when using rigid-component robots as they can exert excessive forces onto tissue. Employing soft robots for surgical procedures dramatically reduces this risk, and therefore the need for tactile sensing as these robots are compliant by nature;
5. Visualisation of the entire surgical field. With visual sensors currently located at the end effector, visualisation is only achieved on entry, on exit, and, for the duration of the procedure is restricted to the target area. More generalised image feedback would allow us to better understand the impact of any and every part of the device upon its immediate environment. This extra set of eyes is likely to contribute to overall MIS safety, although, as already noted, being highly compliant and adaptable, soft robots are somewhat less dependent on this feature.  
Having distilled the key requirements, the task now in hand is to develop solutions that address these issues. These solutions, based on the principles of soft and flexible robotics, will need to build upon the platform that already exists in rigid robotics, enhancing outcomes for MIS and meeting the demands of ever increasingly complex surgery. Alongside any advances in this field, the overarching objective of patient safety will remain forefront.