Author: Denis Avetisyan
A new study explores the potential of teleoperated humanoid robots to provide stable endoscopic visualization and versatile assistance during surgical procedures.

Researchers demonstrate the feasibility of using a humanoid robot as a first assistant in endoscopic surgery, offering a promising new avenue for surgical robotics and human-robot interaction.
Despite ambitious projections surrounding surgical automation, fully realized humanoid robotic assistance in the operating room remains largely unrealized. This limitation is addressed in ‘Humanoid Robots as First Assistants in Endoscopic Surgery’, which details a proof-of-concept demonstration of a teleoperated Unitree G1 humanoid providing stable endoscopic visualization during a cadaveric sphenoidectomy. The successful procedure establishes the feasibility of this form factor for surgical assistance, identifying key engineering challenges and opportunities for autonomous diagnostic applications. Could this work represent a crucial step toward versatile humanoid robots collaborating alongside surgeons in the operating room?
Navigating the Constraints of Surgical Access
Conventional surgical techniques frequently encounter difficulties when accessing tightly constrained anatomical spaces. This limitation stems from the fixed geometry of instruments and the surgeon’s reach, restricting maneuverability within the operative field. Consequently, precise manipulation becomes significantly more challenging, potentially leading to increased surgical time, a higher risk of complications, and suboptimal outcomes. The inability to effectively reach and operate within these confined areas often necessitates larger incisions or more aggressive tissue retraction, contributing to increased patient morbidity. Overcoming these access limitations remains a central goal in the development of less invasive and more effective surgical interventions.
Surgical accuracy hinges significantly on the surgeon’s ability to visualize the operative field, yet achieving a clear and stable endoscopic view proves remarkably difficult within complex anatomical regions. Tissue displacement, bleeding, and the confined spaces characteristic of many surgical sites all contribute to image distortion and obstruction. Maintaining consistent illumination and a wide field of view requires meticulous camera positioning and often, specialized endoscopic techniques. Furthermore, the delicate nature of certain procedures demands minimal tissue manipulation, which can inadvertently compromise visualization. Consequently, surgeons must skillfully balance the need for adequate exposure with the imperative to preserve tissue integrity, often relying on advanced imaging modalities and meticulous surgical planning to ensure precise instrument navigation.
Despite significant advancements, contemporary robotic surgical platforms can encounter limitations when addressing anatomically complex cases. While offering precision and dexterity, these systems often rely on pre-programmed movements and fixed instrument configurations, hindering their ability to dynamically adapt to unforeseen obstacles or variations within the surgical field. This inflexibility becomes particularly apparent when navigating confined spaces or maneuvering around delicate tissues, where subtle adjustments are crucial. Researchers are actively investigating methods to enhance robotic adaptability, exploring innovations in sensor integration, artificial intelligence-driven navigation, and the development of more flexible surgical instruments, with the aim of bridging the gap between robotic capabilities and the nuanced demands of challenging surgical procedures.

Introducing an Articulated Robotic Surgical Assistant
Humanoid robots present a distinct advantage in surgical assistance due to their anatomical flexibility and potential for seamless integration into established operating room setups. Unlike stationary robotic systems, the articulated structure of a humanoid platform, mimicking human limb movement, allows access to surgical sites with greater dexterity and a wider range of motion. This adaptability minimizes the need for significant alterations to existing operating room layouts or workflows, reducing implementation costs and training time. Furthermore, the human-like form factor can facilitate intuitive control and collaboration between the surgeon and the robotic system, potentially improving surgical precision and efficiency.
The Unitree G1 humanoid robot was chosen as the initial development platform due to its articulated structure, providing 29 degrees of freedom. This high degree of freedom allows for a wide range of motion and positioning capabilities crucial for navigating the complex environment of a surgical workspace and manipulating endoscopic instruments. The G1’s physical dimensions and weight are also compatible with standard operating room setups, minimizing the need for infrastructure modifications. Furthermore, its commercially available status and relatively open software architecture facilitate rapid prototyping and iterative development of teleoperation and control algorithms for surgical applications.
Teleoperation of the Unitree G1 robot utilizes a surgeon’s direct input to control the robot’s actuators, while inverse kinematics algorithms translate these commands into the necessary joint angles to achieve a desired end-effector pose. This system allows the surgeon to manipulate endoscopic tools remotely, maintaining dexterity and precision comparable to traditional laparoscopic surgery. The surgeon’s movements are scaled and mapped to the robot’s degrees of freedom, enabling fine motor control within the surgical field. Real-time kinematic calculations are essential to ensure accurate tool positioning and prevent collisions with surrounding tissues, with latency minimized through optimized software and hardware integration.

Validation Through a Cadaveric Sphenoidectomy Procedure
A sphenoidectomy, the surgical removal of the sphenoid bone, was performed on a human cadaver to specifically evaluate the capabilities of a humanoid robot in a complex surgical scenario. This procedure was selected due to the sphenoid’s anatomical complexity and the inherent difficulty in accessing and visualizing the surgical site using traditional endoscopic methods. The study focused on assessing the robot’s ability to maintain a stable endoscopic view and accurately manipulate instruments within the confined surgical space, thereby testing its potential for assisting in minimally invasive skull base surgery. The use of a cadaveric specimen allowed for a controlled environment to evaluate the robot’s performance without the risks associated with live patient procedures.
The endoscopic visual feed for the cadaveric sphenoidectomy was provided by a Karl Storz Image1 HD camera system. To integrate this system with the humanoid robot, a custom adapter was designed and fabricated using 3D printing technology. This adapter ensured stable and secure mounting of the camera, maintaining alignment and facilitating precise endoscopic visualization throughout the procedure. The Image1 HD system delivers high-definition imaging, which was critical for navigating the complex anatomy and performing the delicate surgical maneuvers required for the sphenoidectomy.
A complete sphenoidectomy was successfully performed using a teleoperated humanoid robot to provide endoscopic visualization and surgical access. This demonstrated the robot’s capability to navigate and manipulate instruments within a complex anatomical space, achieving the procedural goals of the sphenoidectomy. The successful completion of this procedure validates the humanoid robot form factor as a potentially viable platform for remotely-operated surgical assistance, suggesting its suitability for tasks requiring dexterity and visualization in constrained environments. Data collected during the procedure confirmed stable image capture and instrument control throughout the entirety of the surgical workflow.
Towards Enhanced Surgical Precision and Tactile Feedback
Post-procedure interviews with surgeons undergoing evaluation of the humanoid robotic platform consistently highlighted its potential to navigate and access difficult-to-reach anatomical sites. The robot’s articulated structure and maneuverability were repeatedly cited as advantageous in complex surgical scenarios, offering possibilities beyond the reach of traditional instruments or even conventional robotic systems. Surgeons specifically noted the platform’s ability to approach surgical targets from non-standard angles, potentially minimizing tissue trauma and improving visualization. While current limitations exist, these initial perceptions suggest the humanoid robot holds promise as a valuable extension of surgical capabilities, particularly in procedures requiring precise access to confined or awkwardly positioned areas within the body.
The study highlighted a significant limitation in the current robotic surgical platform: the absence of haptic feedback for the surgeon. Without the ability to feel tissue resistance or subtle changes in force, precise manipulation and safe tissue handling become considerably more difficult. Surgeons consistently noted that a lack of tactile sensation hindered their ability to confidently navigate delicate anatomical structures and perform intricate maneuvers. Consequently, future development efforts are prioritizing the integration of advanced force sensors and actuators to recreate a sense of touch, coupled with sophisticated control algorithms to translate these sensations into intuitive and reliable force control for the surgeon, ultimately aiming to improve both the precision and safety of robotic surgical procedures.
The true potential of this robotic surgical platform lies in bridging the gap between visual guidance and tactile sensation for the surgeon. The absence of haptic feedback – the ability to ‘feel’ tissue resistance and texture – necessitates improvements in force control mechanisms and the development of a more intuitive control interface. Integrating such technologies promises not only to enhance surgical precision, particularly when accessing difficult-to-reach anatomical sites, but also to mitigate the risk of iatrogenic tissue damage. Refinements in these areas are projected to significantly improve the surgeon’s situational awareness and overall confidence when utilizing the robotic system, ultimately leading to safer and more effective surgical outcomes.
The exploration of humanoid robots as surgical assistants highlights a fundamental principle of systemic design. This research demonstrates how a carefully structured robotic system can augment a surgeon’s capabilities, providing stable endoscopic visualization – a crucial element often demanding significant manual effort. As G. H. Hardy observed, “The essence of mathematics is not to know things, but to understand them.” Similarly, this work isn’t merely about building a robot; it’s about understanding how a robot’s structure – its teleoperation system and physical form – impacts the entire surgical workflow. Every new dependency, such as the need for precise teleoperation, introduces a hidden cost, but the potential benefit – enhanced stability and versatility – suggests a worthwhile trade-off in the pursuit of a more robust and adaptable surgical system.
The Path Forward
The demonstration of stable endoscopic visualization via a teleoperated humanoid robot is not, of course, an end in itself. Rather, it illuminates the inherent complexities within surgical ecosystems. Modifying one element – in this case, the source of endoscopic stability – inevitably shifts the load on others. Human surgeons, for example, must now calibrate their expectations and workflows to accommodate a non-human assistant, a subtle but crucial change in the established order. The true challenge lies not simply in achieving technical feasibility, but in understanding how such a system integrates-or fails to integrate-into the broader operating room dynamic.
Future work must move beyond isolated demonstrations. The emphasis should shift towards quantifying the cognitive burden imposed on the surgeon during human-robot collaborative tasks. What are the limits of attentional sharing? Where does the benefit of robotic assistance plateau, and when does it become a hindrance? Further refinement of haptic feedback systems is necessary, but equally important is the development of intuitive interfaces that anticipate the surgeon’s needs, rather than simply reacting to commands.
Ultimately, the pursuit of humanoid surgical assistants is a meditation on control. The objective isn’t to replace the surgeon, but to extend their capabilities. However, any extension of capability demands a commensurate understanding of the system’s emergent properties. A seemingly simple intervention-a stable camera-can reveal profound implications for the entire surgical process, and it is in these subtle shifts that the true innovations will reside.
Original article: https://arxiv.org/pdf/2602.24156.pdf
Contact the author: https://www.linkedin.com/in/avetisyan/
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2026-03-02 21:30