# Robotic Systems and Navigation Techniques in Orthopedics: A Historical Review
## 2 Robotic Systems (RSs)
### Teleoperated RS  
The da Vinci surgical system (Da Vinci website (accessed on 28 June 2023): [[https://www.intuitive.com/en-us/products-and-services/da-vinci](https://www.intuitive.com/en-us/products-and-services/da-vinci)]([https://www.intuitive.com/en-us/products-and-services/da-vinci](https://www.intuitive.com/en-us/products-and-services/da-vinci))) (Intuitive Surgical, Sunnyvale, CA, USA), as shown in Figure 13, is the most successful teleoperated robotic system for MIS (minimally invasive surgery) in the market. Initially, the system was designed for microvascular surgery [66]. It was used to perform a robot-assisted heart bypass procedure in 1998 in Germany and a robot-assisted radical prostatectomy procedure in 2000 in Paris, France [4]. It received FDA (Da Vinci FDA 2000 file (accessed on 28 June 2023): [[https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K990144](https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K990144)]([https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K990144](https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K990144))) approval in  
Figure 11: Globus ExcelisusGPS for spine surgery. (Reproduced with permission from © Globus Medical, Inc., Audubon, PA, USA).  
Figure 12: TINAVI TiRobot for spine surgery. (Reproduced from _[PERSON] et al._, _Intramedullary Nail Fixation Assisted by Orthopaedic Robot Navigation for Intertrochanteric Fractures in Elderly Patients_, _Orthopaedic Surgery_, _11_: 255–262, _2019_, _John Wiley and Sons_).  
July 2000 for laparoscopic surgery, and since then, the system has expanded its applications into various surgical fields and procedures [66]. Lots of surgeries in a wide variety of fields have been successfully performed by this system, such as prostatectomies, cardiac valve repair, and gynecologic surgical procedures [9]. The da Vinci surgical system further received FDA approval in 2001 for use in prostate surgery, in 2002 for mitral valve repair surgery, in 2005 for gynecological surgery [4].  
The da Vinci system is a teleoperated system, and it consists of two patient-side manipulators (PSMs), one endoscopic camera manipulator (ECM), and two master tool manipulators (MTMs). The surgeon will remotely control the PSMs by physically operating on the MTMs, while the remote scene on the PSM site will be presented to the surgeon via a console by using the ECM. The da Vinci system can translate the surgeon's hands manipulation movements from MTMs to PSMs via the console in real time, such as bending, rotating, grasping, palpating, and cutting, while providing haptic feedback to the surgeon for an immersive experience.  
In orthopedics, the applications of the da Vinci surgical system can be largely limited due to the fact that the system is designed to be more suitable for manipulating soft tissues (e.g., suturing, ablation, needle insertion) than rigid bones (e.g., cutting, burring). Some surgeries regarding soft tissues or nerves in orthopedics have been performed using the da Vinci system. For example, the da Vinci system was successfully used for ulnar nerve decompression at the elbow [6] and supraclavicular brachial plexus dissection and nerve root grafting at the shoulder [67]. Some cases of anterior lumbar interbody fusion (ALIF) in spine surgery were also reported to be successful by using the da Vinci surgical system [68; 69].