Robotic Surgery

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by Darren Housel M.D.

When you think about robotic surgery, there is nothing magical or telepathic going on; it is simply an advanced laparoscopic technique. With the traditional “free hand” laparoscopy, an incision is made (for gynecology it is usually around the belly button area) and a fiber optic scope, with a video camera attached at the end, is inserted. CO2 gas is then pumped into the abdomen, which causes the intra-abdominal organs to separate, allowing the surgeon to evaluate them. Then, typically, additional small incisions are made, and “ports” are set, which are used to place instruments that the surgeon uses to manipulate, cut, cauterize, or whatever is needed to correct the patient’s problem or pathology.

The same thing happens with “the robot”. The difference is in how the camera and instruments are manipulated. The DaVinci robot (the only FDA approved robot) has four arms that are used to manipulate the instruments and camera. The surgeon sits at a console and uses his hand and feet to manipulate the instruments/camera.

Because the robot has superior optics, the image that the surgeon is looking at on the console is in HD and is 3-dimensional. He can see tissue planes and pathology very precisely. The robotic arms also allow extremely precise manipulation of the tissue and pivot at the level of the skin without any lateral movement. With free hand laparoscopy, the ports can move laterally, which, theoretically, can cause trauma (though not often visible). This can cause more post-operative pain. The bottom line is, there is commonly less post-operative pain with robotic surgery.

The DaVinci Robot is a very useful instrument for surgery. It is not appropriate for all laparoscopic procedures, but can be essential for some. Appropriate use can decrease risks to a patient and allow for a much more speedy recovery.

You can read more about the daVinci Robot at their website: http://www.davincisurgery.com/
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