| Robotic surgery is an extension of laparoscopic surgery. Laparoscopy has been practiced for almost 20 years and has transformed surgery in many fields. It has become the standard of care for gall bladder diseases, kidney cancer, orthopedic procedures, and gynecologic diseases.
The United States military worked with the Intuitive Surgical da Vinci System in the 1980s to advance telesurgery-the ability to operate from any location. This system has been available in community practice for approximately three years. Initially used for cardiac surgery, robot-assisted laparoscopic surgery is now applied to thoracic, general, pediatric, gynecologic, and urologic surgery.
The advantages of robotic surgery include 3-D visualization, fine motor skills with the EndoWrist technology, and varying movement ratios. (See photo 1.) The EndoWrist has seven degrees of motion, giving the surgeon dexterity not available using conventional laparoscopic instruments to perform a delicate and precise surgical dissection, reconstruction, or removal of specific tissue.
Standard laparoscopic techniques are applied to perform robotic surgery. Carbon dioxide is inflated into the abdominal cavity. Under direct vision with a camera, laparoscopic ports are strategically placed varying from 5-12 mm in diameter. The da Vinci Robot is then "docked" to the ports. The surgeon sits at the operating console, looks into the InSite vision system, and inserts his thumb and index finger into the master controllers. (See photos 2 and 3.) The surgery is continued by moving the "masters" in true to life motion to activate the EndoWrist robotic arms.
Robotic surgery has many applications in urology, specifically urologic oncology. These include radical prostatectomy (removal of the prostate gland), nephrectomy (removal of the kidney), partial nephrectomy, cystectomy (removal of the bladder), lymph node dissection and adrenalectomy (removal of the adrenal gland). The robot-assisted laparoscopic prostatectomy is the #1 operation performed with the robot. Other applications include reconstructive urology to repair obstructed kidneys. These include pyeloplasties or ureteral re-implants.
Robotic surgery allows patients to experience shorter hospital stays, faster recovery and return to normal daily activities, less blood loss and need for transfusions, less post-operative pain and discomfort, and less scarring with improved cosmetics. (See below.)
If you are interested in robotic surgery please feel free to contact the office for a consultation.
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