A Review on the Form and Complexity of Human–Robot Interaction in the Evolution of Autonomous Surgery

As robotics and intelligence increasingly integrate into surgery, the pivotal role of human–robot interaction (HRI) in surgical procedures and outcomes becomes evident. However, debate rages over whether increasing robot autonomy will result in less human involvement. Some scholars assert that autonomy will reduce human participation, whereas others contend it will result in more complex interactions. To reveal the role of HRI in the evolution of autonomous surgery, this review systematically explores the HRI of robotic surgery with various levels of autonomy. The HRI is examined from both robotic science and clinical practice perspectives, incorporating relevant case studies. Two key components, intention detection and situation awareness, are especially concerned with a brief description of the interfaces and control strategies they rely on. Additional insights are drawn from analogous technologies in aviation, industrial robotics, and autonomous vehicles. The analysis suggests that HRI complexity tends to increase as the robot transitions from no autonomy to conditional autonomy and is predicted to subsequently decrease with a substantial shift in the interaction form when moving toward full autonomy. It is concluded by highlighting challenges from technical and clinical perspectives and delineating research trends in this rapidly evolving field.