Current research status of robots and surgical instruments for natural orifice surgery

Natural Orifice Transluminal Endoscopic Surgery (NOTES) robots and instruments utilize natural body cavities to access the abdomen, mediastinum, or thorax for various operations. This approach offers significant advantages, such as reduced pain, no scarring, minimal trauma, and faster recovery. With advancements in robotic technology, these robots have become an essential complement to traditional surgical methods. A new classification of these devices has been proposed through a literature review, focusing on their structural features and diverse applications. The performance of these robots is examined from the perspectives of their structural characteristics and action execution methods. Key challenges are identified, and future directions for development are discussed, particularly in terms of enhancing precision and expanding the use of these robots in specialties such as cardiac surgery, gynecology, and urology. The review highlights the need for improvements in visual systems, tactile feedback, and materials to enhance the overall surgical performance and versatility of these systems.