The concepts and benefits of hands-on robotic surgery and active-constraint robotics are introduced. The argument is made for systems to be cost effective and simple in order that they can be justified for a large range of surgical procedures. The case is made for robotic systems to have a clear justification, with benefits compared to those from cheaper navigation systems. The need to have robust systems, that require little surgical training and no technical presence in the operating room, is also discussed. An active constraint medical robot, the Acrobot System, is described together with its use in a prospective randomized controlled trial of unicondylar knee arthroplasty (UKA), comparing the performance of the Acrobot System with conventional surgery. Twenty-eight patients awaiting UKA were randomly allocated to have the operation performed conventionally or with the assistance of the Acrobot. The results of the trial are presented together with a discussion of the need for measures of accuracy to be introduced so that the efficacy of the robotic surgery can be immediately identified, rather than having to wait for a number of years before long-term clinical improvements can be demonstrated.

A generic framework for a computer-assisted system for both soft tissue endoscopic surgery and surgical training is being researched and developed. The concept demonstrator is a specific system for transurethral prostatic resection (TURP). The main novelty of the research is that it is not confined to an in vitro trainer system. An in vivo monitoring version of the system, for use in the operating theater, is also being researched. This paper presents the framework's structure and design using the United Modeling Language. It also discusses and justifies the underlying information technologies chosen to implement this approach. Object-oriented concepts and well-proven mathematical tools have been adopted as the foundation of this research and development. The rationale for having chosen such tools is presented. The objectives are to arrive at a system which is modular, general, and reusable.