Surgical Robot History: From PUMA Arms to ABB

A surgical robot does not operate on its own. The surgeon sits at a console and moves the instruments, and the robot turns those hand movements into small, steady motions inside the patient. This post traces how that came about, starting with open surgery and the first borrowed factory arm in 1985, then the da Vinci system and the first remote operation. It then looks at this autumn's news, including a South Carolina kidney transplant done with a robot, and asks where ABB robots fit. ABB does not build a surgical robot, but its arms already work in hospital labs and in the factories that supply operating rooms.

Staff put sterile covers on the arms of a da Vinci Xi before the first robotic operation at William Beaumont Army Medical Center, Texas, 2016. Photo: Marcy Sanchez / U.S. Army via Wikimedia Commons (public domain)

From open incisions to the first factory arm in surgery

For most of the twentieth century an operation meant a large incision, because the surgeon's hands and eyes had to reach the organ directly. A photograph from around 1900 shows Stanley Boyd about to operate in the old theatre at Charing Cross Hospital in London, surrounded by students on tiered benches. Keyhole surgery changed the picture in the 1980s. In 1985 Erich Mühe removed a gallbladder through a laparoscope in Germany, and laparoscopic operations spread quickly over the following decade. The surgeon now worked through small ports with long, straight instruments, watching a video screen while an assistant held the camera.

Stanley Boyd about to operate in the old operating theatre at Charing Cross Hospital, London, around 1900. Photo: Wellcome Collection via Wikimedia Commons (CC BY 4.0)

Robots arrived in the same years. In Canada a team led by biomedical engineer James McEwen built the Arthrobot, which held and positioned a patient's limb on voice command during arthroscopic surgery, and in its first year it helped with more than 60 operations. Also in 1985, surgeons used a PUMA 560, an industrial arm made by Unimation, to aim a biopsy needle into the brain under CT guidance. PUMA stood for Programmable Universal Machine for Assembly, and the same arm family was used on production lines and in university labs, so the first robot to guide a surgical tool was a factory machine.

A Unimate PUMA arm and its controller in a manufacturing systems lab, 1986. A PUMA 560 guided the first robot-assisted brain biopsy in 1985. Photo: University of Limerick Digital Library via Wikimedia Commons (no restrictions)

Purpose-built systems followed. In the late 1980s Imperial College London developed PROBOT for prostate surgery. In 1992 ROBODOC, from Integrated Surgical Systems working with IBM, began milling the cavity in the thigh bone for hip replacements, a job surgeons had done with a mallet and a rasp. In 1994 AESOP from Computer Motion became the first laparoscopic camera holder cleared by the FDA. Computer Motion's ZEUS system was used in the Lindbergh Operation of September 2001, when surgeons in New York removed the gallbladder of a patient in Strasbourg. The da Vinci system had already received FDA approval for general laparoscopic surgery in 2000.

The patient side cart of an early da Vinci surgical system beside an operating table, 2006. Photo: Nimur / Wikimedia Commons (CC BY-SA 3.0)

Robot-assisted surgery in 2026: transplants and milestones

The da Vinci now does far more than gallbladders. On 30 September 2026 the Medical University of South Carolina described one of the first robotic kidney transplants in its new program, the first of its kind in the state. On 29 April Marshall Smith, 48, received a kidney from Russell Schaeffer, a fellow church member he had found through Facebook. Surgeon Dirk van der Windt explained that transplant patients take drugs that slow wound healing, so smaller incisions matter. Smith was in hospital for four days. "Still, it's not a robot that can do the operation by itself," van der Windt said. "It's a platform that helps the surgeon do the operation under higher magnification and greater precision."

A da Vinci Xi patient cart with its four instrument arms, the system family used for robotic kidney transplants today. Photo: Alvarogarciamd / Wikimedia Commons (CC BY-SA 4.0)

Smaller hospitals are joining in. On 23 September Orlando Health St. Cloud Hospital in Florida reported its 100th robotic-assisted operation, less than a year after its program began in January, covering general surgery, urology and gynecology. Regulators are catching up as well. On 28 September MedTech Dive reported a 50-page FDA draft guidance on what makers of robotic surgical systems must submit, covering latency, instrument motion control, visualization, software, cybersecurity, sterilization and training. Comments are open until 24 November, and the FDA plans a two-day workshop on 2 and 3 December about robots with remote teleoperation or autonomous functions.

A surgeon operates from the da Vinci Xi console while the 3D view is mirrored on a monitor, William Beaumont Army Medical Center, 2016. Photo: Marcy Sanchez / U.S. Army via Wikimedia Commons (public domain)

ABB's medical work so far happens in the hospital lab. In October 2019 the company opened a healthcare research hub at the Texas Medical Center Innovation Institute in Houston, with about 20 staff, to automate repetitive lab work. The work there showed YuMi robots tending centrifuges and handling test tubes, and an IRB 1200 doing liquid transfers with a pipette. ABB has also shown a mobile YuMi concept that moves between lab stations. None of these robots touches a patient; they handle samples and supplies, as our post on ABB robots in hospital labs explains.

ABB's mobile YuMi concept, a dual arm robot on a wheeled base, in a hospital lab corridor. Photo: ABB

Where surgical robots go next, from remote theaters to factories

The next step is surgery at a distance. Telesurgery suites already let surgeons train and operate at consoles away from the table, and the Lindbergh Operation showed in 2001 that an ocean in between could work. The FDA's December workshop is a sign that remote and partly autonomous systems are close enough to need rules. For patients this could mean a specialist operating in a rural hospital without travelling there. The open questions are network delay, what happens if the link drops in the middle of an operation, and who is responsible when a remote surgeon and a local team share the work.

Surgeons at the consoles of a telesurgery suite, 2018. Photo: Trevorjchapman / Wikimedia Commons (CC BY-SA 4.0)

Factories are where ABB robots are most likely to show up. Every surgical robot needs instruments, sterile drapes, trays and spare parts made to tight tolerances, and much of that is small-part assembly and machine tending. The new generation IRB 1200, launched in 2025, has pose repeatability down to 0.011 mm and runs on the OmniCore controller, which suits that kind of precise work. Using an ABB arm as the base of a surgical robot would need medical certification, and ABB has not announced any such plan, so the likely openings for now are the supply chain and the lab.

The new generation ABB IRB 1200, launched in 2025, a compact arm for machine tending and small part work. Photo: ABB

A surgical robot costs a hospital a large sum to buy and maintain, so smaller sites such as St. Cloud only invest when they expect enough cases. Every new function, from remote control to automatic suturing, also has to get through the FDA's review. And people need training: surgeons train for hours on simulators before they operate, and the engineers who automate the labs and factories behind them learn to plan robot cells in simulation, often in RobotStudio. Over the next few years most patients will meet a surgical robot the same way Marshall Smith did, with a human surgeon at the console.

ABB's mobile YuMi concept loading test tubes into a centrifuge. Photo: ABB

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