Definition:
Robotic surgery is a technique in which a surgeon performs surgery using a computer that remotely controls very small instruments attached to a robot.
Alternative Names:
Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance
Description:
This procedure is done under general anesthesia (you are asleep and pain-free). The surgeon sits at a computer station nearby and directs the movements of a robot. Small instruments are attached to the robot's arms. The surgeon first inserts these instruments into your body through small surgical cuts. Under the surgeon’s direction, the robot matches the doctor’s hand movements to perform the procedure using the tiny instruments. A thin tube with a camera attached to the end of it (endoscope) allows the surgeon to view highly magnified three-dimensional images of your body on a monitor in real time.
Why the Procedure Is Performed:
Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical cuts than traditional open surgery. The small, precise movements that are possible with this type of surgery give it some advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery. The robot reduces the surgeon’s movements (for example, moving 1/2 inch for every 1 inch the surgeon moves), which reduces some of the hand tremors and movements that might otherwise make the surgery less precise. Also, robotic instruments can access hard-to-reach areas of your body more easily through smaller incisions compared to traditional open and laparoscopic surgery. During robotic surgery, the surgeon can more easily see the area being operated on. The surgeon is also in a much more comfortable position and can move in a more natural way than during endoscopy. However, robotic surgery can take longer to perform, due to the amount of time required to set up the robot. In addition, the robot is expensive to use and may not be available in many hospitals. Robotic surgery may be used for a number of different procedures, including: Robotic surgery cannot be used for some complex procedures. For example, it is not appropriate for certain types of heart surgery that require greater ability to manipulate instruments in the patient’s chest.
References:
Eichel L, McDougall EM, Clayman RV. Basics of laparoscopic urologic surgery. In: Wein AJ. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 7. Gomez G. Emerging technology in surgery: Informatics, electronics, robotics. In: Townsend CM, Beauchamp RD, Evers BM. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 19. Lanfranco AR, Castellanos AE, Desai JP, Meyeres WC. Robotic surgery: A current perspective. Ann Surg. 2004;239:14-21. Oleynikov D. Robotic surgery. Surg Clin N Am. 2008;88:1121-1130.
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