Robotic surgery is a form of laparoscopy, a minimally invasive surgery usually performed in an outpatient setting. Laparoscopy uses an instrument named a laparoscope to examine the organs inside the abdomen. The surgeon makes small incisions about a half-inch each in the abdomen to place the laparoscope and surgical instruments inside the abdomen or pelvis to perform surgery.
Traditionally in laparoscopy, a surgeon holds and directly places the instruments through the incisions. However, in robotic surgery, instruments are placed through the same incisions with the help of robotic arms. The surgeon controls the arms from a control center or console remotely or several feet away from the patient.
What are the differences between robotic and laparoscopic surgeries?
Fundamentally, they are both minimally invasive procedures, providing the most precise surgery and the shortest recovery. But they do have key differences.
| Robotic Surgery | Laparoscopic Surgery | |
| Incision | Tiny incisions | Tiny incisions |
| Surgical instruments | Camera Small instrument Surgeon’s console Endowrist instruments | Camera Small instruments |
| Where your surgeon stands | At the console | Next to the patient |
| How surgery is performed | Surgeon directs the robot’s movements from the console; the robotic instruments in your body respond in real-time | Surgeon operates using the instruments previously inserted in the incisions |
| Level of dexterity | Highest possible; robotic instruments can rotate a full 360 degrees and are more flexible than a human hand or wrist | Limited range of motion compared to robotic surgery. |
| Ability to access hard-to-reach places | Incomparable; the robot has the dexterity to reach previously inaccessible areas of the body | Greater compared to traditional open surgery due to smaller instruments; less than compared to robotic surgery |
| Recovery time | Shorter compared to traditional surgery | Shorter compared to traditional surgery |
| Risk of infection and blood loss | Rare | Rare |
What are the key advantages of robotic surgery compared to laparoscopy?
Surgery by robots has several advantages compared to traditional laparoscopy. First, the console uses high-definition cameras, which allow surgeons to view the abdomen and pelvis clearly. And the depth perception is much better during surgery because of the 3D view, as opposed to a 2D view of traditional laparoscopy. Robotic surgery has greater control of instruments than conventional laparoscopy. Mimicking the surgeon’s hand, instruments in robotic surgery can move in any direction. Better control enables the surgeon to perform more precise movements with great speed. It also allows easy suturing or sewing and knot tying. Robotic surgery is less invasive. The incisions are smaller. Healing happens in 1-2 weeks as opposed to 4-6 weeks for a laparotomy.
What are the disadvantages of robotic surgery?
In robotic surgery, the surgeon has less tactile sensation of the tissue. The movement can be limited when more than one robotic arm is used, and there is less opportunity for surgical assistants to help during surgery since the surgeon controls the robotic arms. Another most significant problem with robotic surgery is the issue of latency — the time it takes for the robot to carry out the surgeon’s commands. It takes a few moments for the computer to communicate with the robotic arms. It makes it difficult for surgeons to respond quickly to problems that occur during the operation. Besides, the time it takes to perform robotic surgery can be longer than laparoscopy. Because of this, the time under anesthesia increases, leading to more potential risks for patients.
What are the standard procedures performed in robotic surgery?
In gynecology, surgery robots are often used for hysterectomy (removal of the uterus), incontinence (inability to hold urine) procedures, myomectomy (removal of fibroids), tubal reconstruction procedures (repair of the fallopian tubes), removal of pelvic masses, removal of endometriosis, and oncologic (cancer) procedures. Theoretically, robotic surgery is suitable in place of any laparoscopy.
Is robotic surgery best for everyone?
The quick answer is no. It is the doctor who must determine whether one is fit for the surgery. The doctor’s decision is based on the patient’s surgical history, the shape of your pelvis, a physical condition that needs treatment, and the experience of the surgeon.
Why are robotic surgeries costly?
The surgical robots are extremely sensitive equipment that costs a lot of money. They cost around $750,000 to over $1 million. Besides the machine cost, the training needed for surgeons to learn how to use the systems is also costly. Because of the extreme cost of the machines and maintenance, the procedures are more expensive than a regular operation. Many in the medical field, however, believe that the surgeries will soon become very common and cheaper.
Is robotic surgery safe?
Robotic and laparoscopic surgeries are technically tricky. When executed correctly, the patient gains several significant benefits with much better short-term and long-term outcomes. It includes less pain, faster recovery, less body disfigurement, less blood loss, less internal body adhesions, less chance of infection, less chance of severe lung problems like atelectasis or pneumonia, etc. However, whether a robot is involved or not, all surgical procedures include risks. Mistakes can indeed happen during surgery of any kind, and when they occur, the risk of complications increases.
The success of surgery highly depends on the experience of the surgeon. Therefore, when robotic surgery is recommended to someone, one should ask as many questions as you can about the surgeon’s experience, training, volume, and complication rates. All in all, surgical robots are merely tools in the hands of the surgeons. There is nothing implicit in robotic surgery that can reduce the possibility of a mistake occurring.
