Robotic Surgery: An Overview and its Advantages

Robotic surgery or robot-assisted surgery is a type of Minimally Invasive Surgery, gaining popularity across several clinical branches in the past few years. Robotic surgery offers surgeons enhanced flexibility to perform complex and intricate procedures with greater precision and control compared to conventional techniques.

Mostly used in minimally invasive surgeries, this cutting-edge approach uses specialised technology, including mechanical arms equipped with tiny surgical instruments, a high-definition 3D camera for magnified views and a surgical console.

The surgeon controls the movements of the camera and instruments from the computer console to perform surgical procedures. By enabling precise access to difficult-to-reach areas, robotic surgery has revolutionised surgical capabilities completely.

Robotic surgery can be used to treat various medical conditions affecting the digestive system, heart, prostate, bladder or other parts of the body.

Types of Robotic Surgery

Robotic surgery is being used extensively in various areas to improve surgical outcomes for patients including:

Laparoscopic Surgery

Robot-assisted laparoscopic surgery combines the control and precision of a computer-programmed surgical robot with the benefits of minimally invasive procedures. The advanced technique improves patient care and overall surgical outcomes through:

• Smaller incisions
• Reduced postoperative discomfort and pain
• Faster recovery
• Shorter hospital stays
• Quicker return to regular activities

Endoscopic Surgery

Robotic surgery offers greater control, stability and agility to surgeons to perform difficult endoscopic procedures, thus improving patient outcomes. Robot-assisted endoscopic surgeries are used in practically all areas of surgery including gynaecological, thoracic, neurologic, orthopaedic and urologic procedures. This approach offers numerous benefits, including smaller incisions, reduced blood loss, faster recovery times and enhanced surgical outcomes.

Prostate Surgery

Robotic surgery allows surgeons to perform various types of prostate surgeries. Robot-assisted prostatectomy is used to remove part or the entire prostate gland to treat various conditions affecting the prostate, commonly for prostate cancer. Robotic prostate surgery has shown promising outcomes, such as reduced blood loss, shorter hospital stays, faster recovery and potentially improved cancer control compared to traditional open surgery.

Cardiovascular Surgery

Robotic surgery is being used for many different cardiovascular-related procedures such as coronary artery bypass, mitral valve repair, tricuspid valve repair, atrial septal defect repair, Patent foramen ovale repair, cardiac tissue ablation and cardiac tumour removal.

Gynaecological Surgery

Gynaecological robotic surgery can be used to treat several gynaecological conditions including uterine fibroids, pelvic prolapse repair, excessive menstrual bleeding gynaecological cancers like ovarian cancer, cervical cancer and uterine cancer, hysterectomy, ovarian cystectomy and myomectomy.

Neurosurgery

Robotics has completely transformed neurosurgery to perform minimally invasive brain surgeries to treat epilepsy, brain tumour and other conditions of the brain.

Orthopaedic Surgery

Robotic orthopaedic surgery is being used for knee and hip replacements, trauma and spinal procedures and knee ligament reconstruction and more.

Others

Robot-assisted surgery helps in various other medical areas for surgery including:

• General surgery
  • Appendectomy
  • Hernia repair
  • Gallbladder removal
• Thoracic surgery
  • Mediastinal mass reduction
  • Lung resection
• Urologic surgery
  • Cystectomy
  • Radical prostatectomy
  • Partial nephrectomy
  • Sural nerve graft
• Gastrointestinal surgery
  • Gastric bypass
  • Colectomy.
  • Gastrectomy
  • Pancreatectomy
  • Proctectomy

How Robotic Surgery Works

Components of a Robotic Surgical System

Typically, the robotic surgical system comprises the following components:

• Surgeon console: Allows a high-definition 3D view of the patient’s anatomy and allows the surgeon to manipulate the wristed surgical instruments.
• Vision cart: Supports the 3D high-definition camera/vision system and enables communication between system components.
• Patient cart: Holds the camera and instruments that can be controlled by the surgeon via the console controls.

Preoperative Planning and Patient Preparation

Preoperative planning steps:

• A proper patient selection must be done for optimal outcomes of robotic surgery.
• The benefits and potential risks of the surgery must be discussed with the patient.
• Training the surgeon and surgical staff with robotics technology is essential.

Patient preparation before the procedure:

• The patient must not have any food or fluids 8 hours before the surgery.
• Some procedures may require bowel cleansing with a laxative or enema.
• The patient must stop taking aspirin, blood thinners, vitamins, supplements or anti-inflammatory medications 10 days before the surgery.

Intraoperative Procedure

• The surgeon makes a few incisions.
• Ports or thin tubes are inserted via the incisions to attach the robotic arms.
• A slender, high-definition endoscope (camera) is introduced via one port.
• Surgical instruments are inserted via other ports for the surgery.
• The surgeon uses the console to operate the robotic arm.
• An assistant helps to change instruments during the surgery as needed.

Advancements in Robotic Surgery

The advancements in robotic surgery have completely transformed the medical landscape. Offering greater unparalleled precision and dexterity, advanced visualisation and greater surgical control, robotic surgery has unlocked new horizons and empowered surgeons to deliver more efficient and safer procedures while revolutionising patient care.

Advantages of Robotic Surgery

Enhanced Precision

The computer-controlled robot offers greater dexterity and range of motion, enabling enhanced precision for surgical procedures. The high-definition 3D camera of the robotic surgical system allows magnified visualisation of the area for better accuracy.

Less Invasive Procedures

Robotic surgery is a minimally invasive procedure using with fewer incisions. The robotic arm enables intricate manoeuvres in tight spaces, only otherwise possible in long incision surgery, minimising the risk of bleeding and infections.

Furthermore, the use of tiny instruments in robotic surgery allows surgeons to perform procedures inside the body, in contrast to traditional methods that require larger incisions and external manipulation.

Reduced Blood Loss

The minimally-invasive nature of robot-assisted surgery ensures that the blood loss during the procedure is minimal, avoiding the need for blood transfusions.

Faster Recovery Time

The body takes less time to recover after a robotic surgery compared to traditional surgery because it is minimally invasive. People can resume their regular activities in a few weeks after the surgery.

Minimal Scarring

Since the procedure is minimally invasive and there is less trauma, the scarring is likely to be minimal.

Increased Patient Safety

Robotic surgery has a lower risk of infections and fewer complications, making it safe for the patient.

Improved Outcomes

Robotic Surgery offers better patient outcomes including reduced blood loss, smaller scars, less pain and discomfort during recovery, lower infection risk, shorter hospital stays and quicker recovery and back to routine activities.

Cost Benefits

Robotic surgery offers potential cost savings due to shorter inpatient stays, resulting in reduced expenses associated with prolonged hospital stays. Quicker recovery times contribute to the economic advantages of robotic surgery by minimising the duration of expensive hospitalisation.

Risks and Limitations of Robotic Surgery

Technical Failures

Although quite uncommon, the main types of robotic malfunctions can include failure of the camera, robotic arms, robotic tower, instruments and optical system. There may also be console defects or software problems.

Surgeon training and Experience

Robotic surgery is a specialised procedure and must be performed only by skilled surgeons who are trained in robotics and have extensive laparoscopic and robotic surgical expertise.

Complications During Surgery

There are certain complications associated with robotic surgery such as nerve palsies caused because of nerve compression or extreme positioning of the body. In some cases, the electric current in the robotic arm may cause burn injuries if it touches the surrounding tissues.

Further, in case of any complications such as scar tissues from previous surgeries, the surgeon may have to switch to an open procedure using larger incisions to complete the surgery.

Cost and Accessibility

Robotic surgery may not be widely available because the cost of the equipment can be quite prohibitive for smaller hospitals and medical centres. So, the technology may be available only in medical establishments that can afford the technology and also have trained, specialised surgeons who are capable of performing robotic surgery.

Legal Issues

Legal aspects of professional liability and litigation in the case of the use of robotic surgery can be complex. This is especially the case with the emerging scenario of a future that surgical robots will be driven by AI (artificial intelligence) and will have the ability to learn and perform routine surgical tasks while being supervised by a human surgeon. Any undesirable outcome can cause the surgeon, hospital and manufacturer of the robotic system to be sued.

Conclusion

Robotic surgery has completely transformed and revolutionised the practice of surgery by blending human expertise with technological skills. It enables patients to receive complex medical treatments with quicker recovery times.

The precision and benefits offered by robotic surgery have redefined surgical outcomes and patient care completely. The remarkable capabilities of robotic surgery will continue to shape the future of surgical innovation.

Frequently Asked Questions (FAQ)

How is Robotic Surgery Performed?

Robotic surgery is performed by using miniature tools that are attached to a robotic arm, which is controlled via a computer. The surgeon makes tiny incisions in the body and inserts a high-definition 3D camera and surgical instruments to perform the surgery.

What are The Benefits Of Robotic Surgery?

The benefits of robotic surgery include lesser bleeding, smaller incisions, less pain and discomfort, minimal scarring, shorter hospital stays and quicker recovery.

Is Robotic Surgery Safe?

Although it is generally a safe minimally invasive procedure, like conventional open surgery, robotic surgery too carries inherent risks such as the likelihood of infection and other potential complications.

What are The Risks Of Robotic Surgery?

Some of the risks of robotic surgery include bleeding, infection and other surgery-related complications like compression and nerve damage.

How Long Does It Take To Recover From Robotic Surgery?

The main advantage of robotic surgery is quicker recovery for patients compared to traditional open surgery. Patients are generally discharged from the hospital after 1-2 days. Most patients will make a full recovery 6 weeks post-surgery and can return to their daily activities.