Development and clinical translation of intelligent assistive devices for minimally invasive thoracic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHU Jiwei ¹ , MA Honghai ¹ , ZHOU Chunlin ² , HE Zhehao ¹ , SHEN Tong ³ , YU Haojie ⁴ ,  WANG Luming ¹ ,  HU Jian ^1,5

1. Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, P. R. China;
2. College of Control Science and Engineering of Zhejiang University, Huzhou Research Institute of Zhejiang University, Huzhou, 310003, Zhejiang, P. R. China;
3. Yibowan Medical Technology (Shanghai) Co., Ltd., Shanghai, 200120, P. R. China;
4. State Key Laboratory of Chemical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, 310027, P. R. China;
5. Key Laboratory of Clinical Evaluation Technology for Medical Device of Zhejiang Province, Hangzhou, 310003, P. R. China;

Corresponding?author：

WANG Luming, Email: dr_hujian@zju.edu.cn; HU Jian, Email: 1507144@zju.edu.cn

Keywords：

Video-assisted thoracoscopic surgery; assistive arms; snake-shaped endoscope; artificial intelligence; visual servoing

DOI：

10.7507/1007-4848.202603060

Video：

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Although video-assisted thoracoscopic surgery (VATS) offers clear advantages, including minimal trauma and rapid recovery, stable intraoperative visualization still depends heavily on the camera assistant. Traditional manual endoscope holding is therefore susceptible to several limitations, including image instability, assistant fatigue, and poor coordination with the primary surgeon. Operating in complex and confined anatomical spaces with a rigid thoracoscope further increases the demands on hand-eye coordination. Thoracoscopic camera-holding technology has progressively evolved from passive support systems to active camera holders and robot-assisted thoracic surgery (RATS) platforms, and is now advancing toward artificial intelligence-driven tracking and intelligent control. Based on this, a series of devices, including multifunctional intelligent assistant arms and active camera-holding arms for thoracic surgery, have been developed and have attracted increasing attention. This article reviews the development of intelligent camera-holding assistant arms and discusses related advances and future directions in the field.

Citation： ZHU Jiwei, MA Honghai, ZHOU Chunlin, HE Zhehao, SHEN Tong, YU Haojie, WANG Luming, HU Jian. Development and clinical translation of intelligent assistive devices for minimally invasive thoracic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(7): 1013-1022. doi: 10.7507/1007-4848.202603060 Copy

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8. Ueno H, Imamura Y, Okado S, et al. Lobectomy for primary lung cancer: a comparison of perioperative and postoperative outcomes between robot-assisted thoracic surgery and video-assisted thoracic surgery. Surg Today, 2025, 55(8): 1162-1172.
9. Kunisaki C, Hatori S, Imada T, et al. Video-assisted thoracoscopic esophagectomy with a voice-controlled robot: the AESOP system. Surg Laparosc Endosc Percutan Tech, 2004, 14(6): 323-327.
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12. Sesma J, Bolufer S, Galvez C, et al. Video-assisted thoracic surgery assisted by articulated arm (AVATS): a new way towards ergonomics and optimization of surgical resources. Shanghai Chest, 2019, 3.
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34. Aizawa K, Haraguchi D, Tadano K. Load reduction control on tool-insertion port for laparoscopic surgical robot using semi-active joints. J Robot Mechatron, 2020, 32(5): 1000-1009.
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39. Yeung CK, Lam KW, Cheung JLK, et al. Overcoming abdominal and pelvic cavity workspace constraints in robotic-assisted NOTES. J Robot, 2020, 2020(1): 8590539.
40. Gonzalez-Rivas D, Bosinceanu M, Manolache V, et al. Uniportal fully robotic-assisted major pulmonary resections. Ann Cardiothorac Surg, 2023, 12(1): 52.
41. Dong J, Xu W, Ji Z. Initial experience of robot-assisted nephroureterectomy without intraoperative repositioning using a new robotic surgical system (KD-SR-01). Minim Invasive Surg, 2024, 2024(1): 2466828.
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44. Marinho MM, Harada K, Morita A, et al. SmartArm: integration and validation of a versatile surgical robotic system for constrained workspaces. Int J Med Robot, 2020, 16(2): e2053.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Development and clinical translation of intelligent assistive devices for minimally invasive thoracic surgery

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