5 world-first systems in autonomous surgery

Credit: Think Surgical

Robotic-assisted surgery is common. Autonomous surgery, where a system plans and executes steps with reduced human control, is rare.

Five systems have cleared that bar with a verifiable world-first claim.

SRT-H completed a full surgical phase without human control

Johns Hopkins University's Surgical Robot Transformer-Hierarchy, or SRT-H, completed the clipping and cutting phase of a cholecystectomy across eight ex vivo gallbladders in 2025. The system used a language-conditioned imitation-learning framework and achieved a 100% success rate without human intervention during the procedure, according to the team's report in Science Robotics.

Source: Science Robotics

STAR performed the first supervised-autonomous soft-tissue surgery

Johns Hopkins' Smart Tissue Autonomous Robot, or STAR, completed laparoscopic intestinal anastomosis on four animal subjects without a surgeon guiding its instruments in 2022. The system planned, adapted, and executed the suturing plan in real time, and researchers reported more consistent results than human surgeons performing the same procedure.

Source: Johns Hopkins University

THINK Surgical automated bone preparation in knee replacement

THINK Surgical's TSolution One is the only FDA-cleared active-autonomous robot for total knee arthroplasty. The system executes fully automated bone milling from a CT-based preoperative plan, a distinct category from haptic-guided systems that require continuous surgeon control.

Source: THINK Surgical

Corindus automated the first robotic movement in vascular intervention

Corindus Vascular Robotics, now part of Siemens Healthineers, received FDA clearance in 2018 for Rotate on Retract, the first automated robotic movement built into its CorPath GRX platform. The feature auto-rotates a guidewire on joystick retraction, an early instance of task-level automation layered onto an otherwise teleoperated interventional robot.

Source: TCTMD

XACT Robotics built the first hands-free interventional robot

XACT Robotics' ACE system became the first hands-free robotic platform to combine image-based planning with autonomous insertion and steering of instruments toward a target, cleared by the FDA in 2019. The system inserts and steers percutaneous instruments to a preplanned target under CT guidance without a physician's hand on the device.

Source: XACT Robotics