"Clipper, Please" ... Robot Assistants Poised to Fill Operating Room Staffing Gaps

Samsung Medical Center's Humanoid Surgical Assistant Robot Demonstration
Recognizes and Delivers Tools via Voice Commands
First Clinical Trials to Begin with Endoscopic Assistance by 2029

"Clipper (the surgical instrument for ligating blood vessels), please."

On September 16, at the 'Humanoid Surgical Assistant Robot Public Demonstration' held at the Samsung Life Ilwon Station Building in Gangnam-gu, Seoul, the robot standing on the left responded as the lead surgeon issued a command. The robot recognized the instructed tool among the surgical instruments and handed it to the surgeon. After use, when the surgeon said, "Take back the tool," the robot located the surgeon’s arm and took the instrument back.

On the 16th, at the Samsung Life Ilwon Station Building in Gangnam-gu, Seoul, during the 'Humanoid Surgical Assistant Robot Public Demonstration' at Samsung Seoul Hospital, a humanoid (left) playing the role of an operating room nurse is trying to pick up laparoscopic surgical instruments from the tray to hand them to the surgeon. Photo by Jungyeon Park

The robot facing the surgeon was holding an endoscope in one hand and a retractor in the other. At the command "follow," the endoscopic screen on the monitor moved in tandem with the surgical instrument. A goat liver was placed on the operating table. One doctor and two humanoids clipped and cut the cystic duct, removing the gallbladder.

On this day, Samsung Medical Center unveiled its in-development humanoid surgical assistant robot for the first time. This project is part of the Korean version of ARPA-H, supported by the Ministry of Health and Welfare and the Korea Health Industry Development Institute's K-Health Future Promotion Team. A total of KRW 13,835,000,000 of government R&D funding will be invested over 54 months by December 2029. Within the ‘ORchestra’ consortium, Rainbow Robotics is responsible for the main robot body, while Aden Robotics develops the gripper and robotic hand. Sungkyunkwan University and Seoul National University are developing the artificial intelligence (AI) technology, and institutions such as the National Cancer Center and Chonbuk National University Hospital are responsible for data collection and clinical validation.

From Remote Surgery to 'Solo Surgery'

The demonstration was conducted in three stages. In the first, one humanoid performed surgery via remote control while two others assisted. When the physician manipulated the control device, the remotely located robot replicated the movements with both arms.

In the second demonstration, the remote-controlled surgery robot was removed and a human surgeon took its place. This was 'solo surgery,' in which one doctor performed surgery with assistance from two humanoids. One robot played the role of operating room nurse: It recognized voice commands, handed over and retrieved surgical instruments, and organized them. Another served as the assistant doctor, simultaneously maintaining the endoscopic field of vision and providing tissue traction. According to the hospital, it is the first case globally to publicly showcase surgery performed collaboratively by two humanoid surgical assistant robots and a human surgeon.

On the 16th, at the Samsung Life Insurance Ilwon Station Building in Gangnam-gu, Seoul, during the Samsung Seoul Hospital's "Humanoid Surgical Assist Robot Public Demonstration," the surgeon is performing surgery by inserting surgical instruments into the laparoscopic surgery simulation device. The humanoid robot, serving as an assistant doctor, is holding the laparoscopic endoscope and maintaining the visual field. Photo by Jungyeon Park

According to the research team, laboratory evaluation showed the robot achieved a 100% success rate in grasping five types of surgical instruments, with a transfer success rate of 98.7%. The robot would begin executing a command within two seconds of receiving a voice instruction. Professor Yongki Chung of the Department of Otorhinolaryngology at Samsung Medical Center, who is leading the development of the surgical assistant robot, explained, "The core is not simply handing over an instrument once, but completing the full tool circulation cycle of 'request, transfer, use, retrieval, and organization.'"

The third demonstration featured Aden Robotics’ multi-jointed robotic hand. When the operator put on a glove-type controller and moved their hand, the robot hand gripped and pulled the surgical retractor. Sensors attached to each joint collected data on gripping force. The research team plans to implement this hand in the operating room by the end of the project period.

On the 16th, at Samsung Life Insurance Irwon Station Building in Gangnam-gu, Seoul, a researcher from Aydin Robotics is operating the multi-jointed robotic hands of a humanoid robot, wearing glove-type remote control devices on both hands, during the 'Humanoid Surgical Assistant Robot Public Demonstration' at Samsung Medical Center. Photo by Jungyeon Park

A Solution for Operating Room Staffing Shortages ... "Expected to Be Economical"

The development of humanoid surgical assistant robots is driven by workforce shortages in operating rooms. Regional and smaller hospitals find it difficult to recruit skilled surgical assistants, and the shortages are even more acute during night or emergency operations. The research team explained that if robots take over simple and repetitive tasks such as passing instruments and holding endoscopes, it will reduce the burden on medical staff.

The team believes humanoid robots can offer a solution to staff shortages while also alleviating labor costs. Professor Chung said, "Filling just one operating room nurse’s position 24 hours a day requires five people. Even at an annual salary of KRW 50,000,000 each, it totals KRW 250,000,000 per year. The cost of introducing robots will not exceed that. If a robot can fully substitute for one nurse, the investment could be recouped in just one year."

On the 16th, at the Samsung Life Ilwon Station Building in Gangnam-gu, Seoul, three humanoid robots surrounded a surgical simulation device demonstrating remote surgery assistance during the 'Humanoid-type Surgical Assistant Robot Public Demonstration' at Samsung Medical Center. The robots, dressed in surgical gowns, were assigned roles according to the markers on their backs: surgical nurse (left), endoscopy and traction assistant (center), and remote surgical operator (right). Photo by Jungyeon Park

Challenges: Speed, Bleeding Environment, and Legal Framework

There are many hurdles to commercialization. On this day, the robots delivered and retrieved tools more slowly than humans. Professor Chung commented, "It's not as fast as humans yet, but by the end of the project the surgical assistant robot will be fast enough to match human performance."

Ensuring AI reliability in actual surgical environments, including those involving bleeding, also remains a challenge. More research is needed on intricate tasks such as sensing tissue tension for precise traction and advanced procedures like incision and suturing. There are currently no legal or institutional standards in place for bringing humanoid robots into operating rooms.

The research team aims to conduct the first clinical trials in 2029, starting with low-risk tasks such as maintaining endoscopic vision, then expanding to laparoscopic field adjustment and tissue traction. The targeted procedures are cholecystectomy and pituitary tumor resection, and clinical trials will be carried out at four hospitals.

Professor Chung stated, "The timing of introduction will vary depending on the role assigned to the surgical assistant robot. By the end of the project, the task of holding the endoscope should certainly be clinically feasible."

Samsung Seoul Hospital humanoid surgical assistance robot development team. From the right: Yonggi Jung, Professor of Otorhinolaryngology; Jooyoung Bae, Professor of Plastic Surgery; Gyuhwan Jeong, Professor at the Intelligent Medical Robot Research Center; Namgi Oh, Professor of Transplant Surgery. Samsung Seoul Hospital

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