Surgical robotics may be entering a fascinating new era. And, paradoxically, it looks very much like the beginning.
We are starting to meet robots in our everyday life. Have you not, yet? You will not have to wait for long. You might, for example, meet a barista robot. The haircut robot was an AI creation, but this is not (it is a real photo), as many of you for sure already know,
So, one of the most interesting developments in medical robotics today is the arrival of large “generalist” robotic companies into surgery. Among them, KUKA is particularly noteworthy. For decades, KUKA robots have been synonymous with industrial automation: automotive factories, aerospace engineering, precision manufacturing, and collaborative robotics. Now, the same company is aggressively expanding into medical applications with platforms such as the KUKA LBR Med, the first robotic arm specifically certified for integration into medical devices.
Why is this so interesting? Because surgical robotics itself was born exactly this way. The history of robotic surgery did not start with purpose-built surgical robots. It started with industrial robotic arms adapted for medicine. The classic example is the legendary PUMA. The PUMA (Programmable Universal Manipulation Arm) was developed by Victor Scheinman at Unimation, one of the pioneering robotics companies. Initially designed for General Motors for industrial assembly tasks, the system rapidly became popular in research environments because of its flexible programming language and operational versatility. In 1985, the PUMA 560 robot was used to guide the insertion of a needle into the brain under CT guidance, becoming one of the first true milestones in surgical robotics.
Now history seems to be repeating itself. But this time, the technological ecosystem is completely different. Modern industrial robots are no longer rigid factory machines isolated behind safety cages. Collaborative robotic systems (“cobots”) now offer force sensing, submillimetric precision, haptic feedback, AI integration, image guidance compatibility, and human-robot interaction capabilities that were unimaginable twenty years ago.
This evolution is especially relevant for skull base and H&N surgery. Few surgical fields demand the level of precision required in cranial base surgery. We operate millimeters away from the carotid artery, optic nerve, facial nerve, brainstem, cochlea, and lower cranial nerves. Human dexterity alone is often pushed to its limits. This is exactly where collaborative robotic systems may become transformative.
Robotic assistance in skull base surgery is rapidly evolving toward image-guided drilling, haptic-assisted navigation, virtual fixtures, force-controlled instrumentation, immersive virtual planning, and autonomous or semi-autonomous bone work. The recent review on robotic skull base surgery highlights how these systems are progressively moving from experimental environments toward clinically relevant applications, particularly in lateral skull base and endoscopic endonasal surgery.
And this is where companies like KUKA become extremely important. Unlike traditional surgical robotic companies focused on a single platform, industrial robotics companies already possess decades of expertise in:
- Precision robotic motion
- Real-time collision avoidance
- Force sensing
- Human-machine collaboration
- AI-enhanced automation
- Scalable manufacturing
- Open integration architectures
In other words: they already solved many of the hardest engineering problems. Medicine now becomes an application layer.
Industrial robotics companies already possess decades of expertise. They have already solved many of the hardest engineering problems. Medicine now becomes an application layer.
For H&N Robotic Surgery this is important. The next generation of robotic surgery may involve collaborative robotic drilling, autonomous bone removal with safety boundaries, intelligent endoscope positioning, augmented-reality anatomical overlays, and microsurgical robotic assistance inside spaces previously considered inaccessible.
Future robotic surgery may not depend on one closed proprietary platform. Instead, we may see modular ecosystems where navigation systems, AI planning software, endoscopic visualization, augmented reality, and collaborative robotic arms work together dynamically. This could radically accelerate innovation.
J Granell. May 12, 2026
Faoury M, Patel P. Robotic-Assisted Surgery in Skull-Base Procedures: Advances, Applications, and Emerging Innovations. Int Arch Otorhinolaryngol. 2026 Apr 30;30(2):1-7. doi: 10.1055/s-0046-1818631.