Technological advances have touched nearly every aspect of our daily lives. This is certainly true of medicine as well.
Robotic-assisted surgery is commonly advertised by health care systems, hospitals and surgeons, but I suspect many people may not fully understand what this means for patients undergoing surgery. Robotic surgery is a method to perform surgery using very small tools attached to a robotic arm. The surgeon controls the robotic arm with a computer console that is usually several feet away from the operating table.
Robotic surgery, like laparoscopic surgery, uses small ports placed though the skin and into the abdominal cavity. Laparoscopic surgery has been performed since the early 20th century, but did not gain significant popularity and widespread use until much later in the 1970s and ’80s. To perform a laparoscopic surgery, small incisions are made for port insertion, usually three to five ports, and the surgical tools and a camera are placed through the ports. The surgery is completed using instruments controlled by the surgeon’s hands.
Robotic surgery is similar, only instead of these tools being controlled directly by the surgeon’s hands, they are controlled by robotic arms the surgeon controls via the computer console.
So why exactly is this better? Well, for one, it’s not always. There are some surgeries that still need to be done from an open or purely laparoscopic approach. But for many surgeons, especially urologists, gynecologists and general surgeons, the robot has many advantages.
One of the biggest advantages is the visualization afforded by the robotic camera. It is a high-definition camera that also provides 3D depth perception. When you’re sitting in the console, you can see incredibly fine details. Additionally, the robotic arms allow the surgeon to position instruments in places the hand cannot.
As a urologist, I’m often working deep within the pelvis, which can be a very small space. Prior to the robot, many portions of procedures were extremely difficult due to a lack of clear vision. For example, when I am removing a man’s prostate gland because of cancer, I must sew the urethra back to the bladder. This was difficult during open surgery due to the lack of vision and many men had urine that would leak from this connection. With the robot, the reconstruction is done with near-perfect vision and a water-tight connection is more easily achieved.
The benefits are certainly not limited to the surgeon. Patients enjoy shorter hospital stays on average as well as fewer blood transfusions post-operatively and less pain.
Since the first robotic surgical system was approved for use in the United States in 2000, thousands of robotic procedures have been completed. This is a proven technology that is here to stay and is certainly in its infancy. With the advent of more robust wireless technology, our world is going to be more connected than ever before. It is likely only a matter of time before a surgeon sitting in the United States can complete a robotic surgical procedure on a patient in the operating room in Australia.
The robot is merely a tool a surgeon has in a toolbox to use when appropriate. The training required to become proficient in robotic surgery is no less than open surgery, and the surgeon is in complete control of all motions the robotic arms make. We are fortunate to have this technology available to patients in Paris and surrounding areas.
If you or a loved one are undergoing a robotic surgery in the future, hopefully this will shed some light on what that means.