Robotic surgery is a new innovative approach to surgery that overcomes the limitations of traditional surgery and conventional minimally invasive or laparoscopic surgery. Robotic surgery is performed through small incisions that introduce miniaturized wristed instruments and a high-definition 3-D camera. The surgeon is seated at the console where the state-of-the-art robotic computer system translates the surgeon’s hand movements into precise micro-movements of the instruments. The system cannot make any decisions on its own. The robotic system requires that every maneuver be performed with direct input from the surgeon.
Robotic surgery has its most profound effect with pelvic surgery, including rectal cancer, rectal prolapse and enterocele repair. The surgeon can operate with better visualization, precision, dexterity and control than possible traditional surgical approaches, laparoscopic or open.
What are the benefits of robotic surgery?
The same benefits seen with laparoscopic surgery are also seen in robotic surgery including:
- Less postoperative pain and reduction in need for pain medication
- Quicker return to tolerating a diet
- Shortened hospital stay
- Earlier return to daily activities
- Improved cosmetic results
In addition to these benefits, some of the benefits that are more specific to robotic surgery are:
- Less injury to the nerves in the pelvis that control sexual function and bladder function
- Excellent clinical outcomes for cancer control
- More sphincter-sparing techniques especially in males and obese patients thus avoiding a permanent colostomy
- Less blood loss
Is Robotic Surgery Safe?
Like laparoscopic surgery, robotic surgery is as safe as traditional open surgery and has been shown to be as effective as traditional open surgery when performed by an appropriately trained surgeon. Robotic surgery is essentially laparoscopic surgery with some additional technologic advancement, such as 3-D vision instead of a 2 dimensional flat screen which the operating surgeon uses to view the operative field. Robotic surgery has the same benefits of laparoscopy, again with some important improvements, such as less risk of injury to pelvic nerves that control sexual and bladder function and improved ability to preserve the anal sphincter muscles to avoid a permanent end colostomy.
Who is a candidate for Robotic Surgery?
The first step in deciding whether a robotic approach is feasible will be made during pre-operative consultation – this will be based on your specific condition, the extent of disease and your past medical/surgical history. The final determination is made at the onset of surgery. Upon entering the abdomen, the surgeon will evaluate the abdominal cavity and determine if it is safe to proceed in a laparoscopic and/or robotic fashion. It is not unusual for a hybrid approach to be used; indeed, some of the surgery done with traditional laparoscopy and often the pelvic dissection performed using the robotic approach. As with any intestinal surgery, certain risks related to anesthesia, bleeding, infection and bowel leaks (anastomotic breakdown) exist. These risks depend on each patient’s pre-operative health, the condition being treated and the specific operation being performed. An assessment and minimization of these risks is a key element of successful surgery and will be discussed prior to deciding on surgery. Several medical studies have shown that patients undergoing abdominal surgery performed by surgeons specialized in Colon and Rectal Surgery meet with improved outcomes.