Intelligent therapeutic robotic-assisted surgery as the next frontier of precision oncology

Robotic-assisted surgery has evolved over the past two decades from mechanically assisted laparoscopy into an increasingly intelligent, biologically responsive therapeutic modality. While early robotic systems primarily enhanced dexterity and visualization, contemporary platforms now integrate artificial intelligence, advanced imaging, real-time biosensing, and pharmacological interfaces, extending surgical capability beyond physical manipulation alone. Robotic-assisted surgery is thus emerging at the intersection of digital intelligence and molecular medicine, with the potential to sense, interpret, and modulate tumor biology during operative intervention. However, current literature remains largely procedure-centered and mechanically focused, offering limited synthesis of how robotic systems converge with pharmacology, artificial intelligence, and systems medicine to actively regulate oncologic processes. A cohesive, oncology-oriented framework integrating intelligent robotics with intraoperative drug delivery and real-time biological feedback is notably lacking. This narrative review critically consolidates recent advances in pharmacologically enabled robotic platforms, AI-driven intraoperative cognition, and emerging closed-loop surgical-pharmacological architectures. It examines next-generation systems incorporating localized drug delivery, molecular diagnostics, and real-time pharmacodynamic monitoring, while discussing translational pathways and regulatory considerations shaping semi-autonomous oncologic ecosystems. By reframing robotic-assisted surgery as a dynamic therapeutic science rather than a purely mechanical tool, this review highlights a new frontier in precision oncology that has the potential to enable individualized, adaptive, and predictive cancer interventions.