What is the difference between a robotic surgery system and a robotic surgical assistant?
A robotic surgery system is designed to perform the surgeon’s movements through robotic instruments. The surgeon operates the system, often from a console, and the robot becomes the interface between the surgeon and the patient. A robotic surgical assistant has a different philosophy. The surgeon remains at the operating table and performs the procedure directly, while the robot provides an additional pair of hands: holding the camera, maintaining exposure, positioning instruments, or assisting with repetitive tasks. The distinction may seem subtle, but it represents a fundamentally different approach to surgical robotics.
In fact, robotic surgical assistants are not a new concept. They are arguably at the very origin of modern surgical robotics. One of the earliest and most influential examples was AESOP (Automated Endoscopic System for Optimal Positioning), developed by Computer Motion and introduced in the 1990s. AESOP was essentially a robotic endoscope holder, allowing the surgeon to control the laparoscopic camera by foot or voice commands. It later became part of the ZEUS robotic system, illustrating how the simple robotic camera holder evolved into a complete robotic surgical platform.
Several other robotic camera assistants subsequently reached clinical use, including EndoAssist, ViKY, FreeHand, EMARO and SOLOASSIST. Most were designed primarily to control and stabilize the endoscope, replacing the human camera assistant.
Today, Maestro™ from Moon Surgical takes this concept a step further. Maestro is a two-arm robotic surgical assistant capable of positioning both laparoscopes and instruments, while allowing the surgeon to remain directly at the operating table. It is compatible with a wide range of standard 5–10 mm laparoscopic instruments, and its ScoPilot™ technology provides intelligent control of the laparoscope. Maestro is currently available in the US and EU.
At present, there are no robotic surgical assistants specifically indicated for Head&Neck Surgery. But an endoscopic surgical assistant could potentially provide useful assistance in transoral endoscopic surgery, endoscopic sinonasal surgery (including anterior skull-base procedures), and perhaps endoscopic ear surgery (including lateral skull-base surgery).
This is not about replacing the surgeon, but about giving the surgeon an extra pair of hands.
J Granell. Sep 4, 2026