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Gagner. Mini-invasive Surg 2021;5:12 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.23

Editorial Open Access

Robotic surgery: is it really different from
laparoscopy? a critical view from a robotic pioneer

Michel Gagner 1,2

1 Department of Surgery, Hôpital du Sacre Coeur, Montreal, QC H2Y 0A4, Canada.
2 Westmount Square Surgical Center, Westmount, QC H3Z 2P9, Canada.
Correspondence to: Prof. Michel Gagner, Department of Surgery, Hopital du Sacré Coeur, 315 Place D'Youville, Suite 191,
Montreal, QC H2Y 0A4, Canada. E-mail: gagner.michel@gmail.com
How to cite this article: Gagner M. Robotic surgery: is it really different from laparoscopy? a critical view from a robotic pioneer.
Mini-invasive Surg 2021;5:12. http://dx.doi.org/10.20517/2574-1225.2021.23
Received: 2 Feb 2021 Accepted: 24 Feb 2021 Published: 9 Mar 2021

Academic Editors: Andrew A. Gumbs, Giulio Belli Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

I got involved in robotic surgery more than 25 years ago, with the development of our own robotic arm,
as an assistant holder for the laparoscope, the first Canadian laparoscopic robotic arm, a vertical like
[1]
AESOP laparoscope holder . It was built by using an industrial robotic arm from CRS Robotics corporation
( Burlington Ontario) used in automated labs, transformed with the help of engineers from the Polytechnique
of Montreal of the University of Montreal, and eventually added the first voice activation from Northern
[2]
Telecom, before Computer Motion’s HERMES system . However, it was never commercialised, and I
started to work at the Cleveland clinic in mid-1995, working in partnership with Computer Motion for the
clinical developments of the ZEUS robotic system. One of the first concepts of using robotic systems for
surgery was the parallel credence of the employment of “master-slave” manipulators used in the nuclear
industry for the handling of deadly radiation materials. Hence, I visited at the invitation and organisation
of the late Prof. Gerard Buess the “master-slave” manipulator installed at the Karlsruhe Nuclear Research
[3]
Center, in Karlsruhe Germany . This consisted of a seat with hand holding large crude manipulators,
watching through a window, two arms picking up radiation containers, and then a crude template for a
“robotic system” for surgery.

At the headquarters of Computer Motion in Goleta California, I was the very first to demonstrate a
complete robotic-assisted mammary-coronary anastomosis in the porcine model, demonstrating the
true potential of robotic surgery. My experience in 1995-1997 led us to believe that robotic systems
were especially made for small anastomosis, by having the first ZEUS system ever built, at the Cleveland
clinic in 1996, after convincing the legendary CEO Dr. Floyd Loop, a cardiac surgeon himself, who got

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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