In this way, robotic-assisted surgery (RAS) has gained popularity in several surgical specialties and many institutions are now investing in medical robotic technology for applications in general, urological, cardiac, gynecological, and neurological surgery. This new and exciting technology has been shown to be safe, have leave a message better or comparable outcomes, and can be cost effective when compared with conventional surgical approaches [1�C3]. This has raised interest in its use in other surgical fields, such as otolaryngology and head and neck surgery. Head and neck and several airway procedures have been associated with a large amount of surgical dissection with associated large surgical incisions. This can result in major tissue damage, functional impairment, and a decreased quality of life [4].

However, with minimally invasive approaches, the improved video imaging, endoscopic technology, and instrumentation has provided the surgeon with multiple endoscopic access points. While the advance of endoscopic technology has increased surgeon capabilities, the technique still has several challenges associated with it. Examples include: (1) the limited range and degree of motion of instrumentation, (2) operative field limited to ��line of sight�� (3) lack of three-dimensional imaging of the operative field (4) amplification of physiologic tremors, (5) compromised dexterity and (6) mismatched hand-eye coordination [5, 6]. With these challenges in mind, the development of surgical robotics was rooted in the desire to overcome the limitations of current endoscopic technologies and to expand the benefits of MIS [7].

2. The Evolution of the Current Robotic System The first robotic surgical system developed was the Puma 560, which was used in 1985 to perform neurosurgical biopsies with increased precision. Since this time, a series of robots have been developed. However, the only FDA approved and actively marketed system (2009, for Transoral Robotic Surgery��TORS [8]) for head and neck surgery is the da Vinci Surgical Robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). This system has its roots in the National Aeronautics and Space Administration’s (NASA) desire to develop a method to provide surgical care to orbiting astronauts via telepresence surgery.

[7, 9] Interest in this technology came from both the Stanford Research Institute and the US Army, which saw promise in bringing the technology to the battlefield to provide surgical Anacetrapib care to a wounded soldier as soon as possible��even with the surgeon operating remotely. Thereafter, in 1995, the Intuitive Surgical Corporation was set up to produce telerobotic systems for commercial public use, where it was first used in general surgery. Cadiere et al. [10] reported the first two cases of robot-assisted fundoplication in 1999, and Weber et al. [11] reported the first robot-assisted colectomy in 2002.