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The role of technology in minimally invasive surgery: state of the art, recent developments and future directions
  1. Michele Tonutti,
  2. Daniel S Elson,
  3. Guang-Zhong Yang,
  4. Ara W Darzi,
  5. Mikael H Sodergren
  1. Department of Surgery and Cancer, The Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
  1. Correspondence to Mikael H Sodergren, Department of Surgery and Cancer, The Hamlyn Centre for Robotic Surgery, Institute of Global Health Innovation, Imperial College London, 3rd Floor Paterson Centre, South Wharf Road, Paddington, London W2 1PF, UK; m.sodergren{at}


The diffusion of minimally invasive surgery has thrived in recent years, providing substantial benefits over traditional techniques for a number of surgical interventions. This rapid growth has been possible due to significant advancements in medical technology, which partly solved some of the technical and clinical challenges associated with minimally invasive techniques. The issues that still limit its widespread adoption for some applications include the limited field of view; reduced manoeuvrability of the tools; lack of haptic feedback; loss of depth perception; extended learning curve; prolonged operative times and higher financial costs. The present review discusses some of the main recent technological advancements that fuelled the uptake of minimally invasive surgery, focussing especially on the areas of imaging, instrumentation, cameras and robotics. The current limitations of state-of-the-art technology are identified and addressed, proposing future research directions necessary to overcome them.

  • Surgical robotics
  • Image-guided surgery
  • Imaging
  • Laparoscopy
  • Minimally-invasive surgery

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  • Contributors All authors viewed and approved the final manuscript. MT carried out the literature review, wrote the first draft and edited subsequent version of the manuscript, editing the changes made by the other authors. He also wrote the self assessment questions, main research points and selected the key references. MHS proposed the idea of the review and acted as main supervisor during the writing process. In addition, he offered his knowledge and experience as a minimally invasive surgeon. DSE provided his expertise in medical imaging, expanded multiple sections in the imaging chapter, and performed a thorough review of the manuscript. G-ZY and AWD reviewed and corrected the final draft, suggested additional references and contributed their experience in the fields of medical engineering and surgery.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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