For the past decades medical robotic solutions were mostly based on the concept of tele-manipulation. While their design was extremely intelligent, allowing for better access, improved dexterity, reduced tremor, and improved imaging, their intelligence was limited. They therefore left cognition and decision making to the surgeon. As medical robotics advances towards high-level autonomy, the scientific community needs to explore the required pathway towards partial and full autonomy. Here, we introduce the concept of Dyadic Partnership(DP), a new paradigm in which robots and clinicians engage in intelligent, expert interaction and collaboration. The Dyadic Partners would discuss and agree on decisions and actions during their dynamic and interactive collaboration relying also on intuitive advanced media using generative AI, such as a world model, and advanced multi-modal visualization. This article outlines the foundational components needed to enable such systems, including foundation models for clinical intelligence, multi-modal intent recognition, co-learning frameworks, advanced visualization, and explainable, trust-aware interaction. We further discuss key challenges such as data scarcity, lack of standardization, and ethical acceptance. Dyadic partnership is introduced and is positioned as a powerful yet achievable, acceptable milestone offering a promising pathway toward safer, more intuitive collaboration and a gradual transition to full autonomy across diverse clinical settings.

翻译：过去几十年，医疗机器人解决方案主要基于远程操控概念。尽管其设计极为精妙，能够实现更好的通路、更高的灵活性、减少震颤并改进成像，但它们的智能程度有限，因此将认知和决策留给了外科医生。随着医疗机器人向高自主性发展，科学界需要探索迈向部分及完全自主性的必要路径。在此，我们引入二元伙伴关系(DP)这一新范式，即机器人与临床医生开展智能、专业的互动与协作。在动态交互协作过程中，二元伙伴将依靠生成式AI（如世界模型）及先进多模态可视化等直观的先进媒介，共同讨论并商定决策与行动。本文概述了实现此类系统所需的基础组件，包括临床智能基础模型、多模态意图识别、共同学框架、先进可视化以及可解释、基于信任的交互。我们进一步讨论了数据稀缺、缺乏标准化及伦理接受等关键挑战。二元伙伴关系被定位为一个强大且可实现、可接受的里程碑，为在多样化临床环境中实现更安全、更直观的协作及逐步过渡到完全自主性提供了一条有前景的途径。