Robot-Assisted Surgery

Overview

Robotic or robot-assisted surgery combines cutting-edge computer technology with the expertise of professional surgeons. This device displays a 10x magnified, high-definition, 3D view of the body's complicated anatomy to the surgeon. While electronic personal assistants make it easy to play your favorite song or replenish your toilet paper, robotic aided surgery is extending surgical capabilities while also changing the face of medicine.

What is Robot-Assisted Surgery?

The da Vinci surgical system, a unique mix of technologies that includes specialized "arms" for carrying tools and a camera, as well as a magnified screen and a console, is being used in robotic surgery.

While scientists began investigating the use of robots in surgery in the 1960s, robotics were not employed during surgical procedures until the 1980s. Hap Paul, DVM, and William Bargar, MD, created an orthopedic image-guided system to aid in prosthetic hip replacement surgeries in the 1980s.

In the United States, the Food and Drug Administration (FDA) authorized robotic surgery in 2000. Since then, hospitals throughout the country have progressively began to use robotic surgery to treat a wide range of illnesses.

Robotic aided surgery, such as the da Vinci Xi Surgical System, allows doctors to perform minimally invasive surgery on even the most difficult cases. Surgeons use a nearby console to operate the arms of the robotic devices within the body and watch 3D views of the surgical site. The tiny robotic arms enable surgeons to make smaller, more precise incisions, resulting in less discomfort and blood loss for the patient. The robot's artificial wrists resemble human wrist motions, excluding the inherent hand tremor.

GI, cardiothoracic, gynecologic oncology, otolaryngology (head and neck), and urologic surgery are among the specialities that use robotic-assisted surgery. Each treatment is carried out by a highly qualified team of surgeons, nurses, and technicians who have been particularly trained to use robotic surgical equipment.

Benefits to surgeons and patients

There are several advantages to robotic surgery. The following are some of the primary advantages of having robotic surgery rather than traditional surgery.

• Minimal Invasion

Robotic surgery is nearly typically performed in a minimally invasive manner. Minimally invasive surgery uses tiny incisions, which reduces the possibility of discomfort or harm to the surrounding ligaments and tissues. The small incisions used in minimally invasive surgery also serve to limit blood loss to a minimum. The three-dimensional vision that surgeons get during robotic surgery, in particular, provides them with a better view of the blood arteries, allowing them to guarantee that the patient's blood levels stay constant during the procedure.

Furthermore, smaller incisions need less probing of the body, reducing overall operation time and allowing the body to begin mending and recuperating sooner. Because of the lower incision sizes, minimally invasive surgical treatments produce less scarring. Most individuals have a valid cosmetic concern about a tiny scar, which robotic surgery addresses by making small, keyhole incisions.

Because robotic surgery is less invasive and causes less tissue damage, patients who undergo robotic surgery often have less muscle damage, less discomfort, and shorter hospital stays than those who undergo traditional surgery. Patients who undergo robotic surgery spend less time in the hospital and can perhaps resume their daily activities sooner.

• Optimal Accuracy

Surgeons can undertake more precise surgeries because to robot-assisted surgery. Improved surgical precision reduces the chance of mistake during the procedure and speeds up the healing process. Robotic surgery, in particular, improves accuracy in the following areas:

• • Visibility: The surgeon can plainly observe what has previously been successfully achieved and measure their next moves thanks to the three-dimensional navigation technology utilized during robotic surgery.
  • Predictability: Having a precise image of what will be cut and how it will be sliced gives the surgeon better control over the procedure.
  • Precision: During every surgical operation, even doctors with absolutely calm hands run the danger of trembling or faltering. The robotic tools used in robot-assisted surgery reduce the chance of human error by providing an extra layer of accuracy to safeguard patients from unintentional errors.
  • Consistency: Robotic arms are more constant than human hands, in addition to being more precise. Robot-assisted surgeries yield more consistent results than traditional surgical approaches.
  • Adaptability: Robotic surgery allows a surgeon to change strategies at any time to achieve surgical objectives. Throughout the process, the surgeon has the option of taking over the operation manually anytime they think it essential.
    

• Fewer Complications

The possibility of infection is one of the most serious risks associated with standard surgical techniques. However, the little incisions utilized in minimally invasive surgery significantly lower this danger. Instead of, for example, cutting up the whole abdominal cavity for an operation, robotic surgery makes the wound size significantly smaller and simpler to monitor.

Other post-surgical issues, such as joint impingement or excessive blood loss, can also be reduced with robotic surgery. A robot-assisted surgery promotes a quick and complete recovery by causing less blood loss and requiring fewer blood transfusions. Because robotic procedures have a low complication rate and a rapid recovery period, patients are more satisfied.

• A Natural-Feeling Joint

Patients who had robot-assisted joint replacement surgery say their new joints feel natural and pleasant. Despite having joint discomfort before to surgery, individuals who undergo robotic surgery for joint replacement had less weight-loading difficulties following the treatment. This is a significant benefit since weight-loading concerns can lead to other health issues in the spine.

Most patients who have robotic surgery for a joint replacement have quick recovery times and no difficulty resuming to their pre-operation habits. Because robot-assisted surgery is minimally invasive, patients have a better chance of regaining full mobility and feeling absolute freedom of movement.

Who are Good Candidates for Robotic-Assisted Surgery?

Almost any patient qualifies for robotic surgery. Because robotic-assisted surgery has so many advantages, it is suitable for a wide range of patients. However, there are a few people who are not suitable for robotic surgery. Those with the following medical problems should exercise caution when contemplating robotic surgery:

• A current infection or high risk of infection
• Significant bone thinning
• Obesity or other weight issues

Da Vinci Surgical System

The da Vinci Surgical System, which was authorized by the US FDA (Food and Drug Administration) in 2000 and has been utilized in hundreds of surgeries since, is the most often used technology for robot-assisted surgery. Miniaturized surgical tools are installed on three robotic arms and a fourth arm with a magnified 3D camera on the da Vinci SI.

A console allows the surgeon to see the site while manipulating the equipment with finger-operated master controls. The surgeon can choose the movement scale: For example, on a four-to-one scale, the tip of the specific robotic arm will move one inch for every four inches that the surgeon's hand moves.

What are the Types of Robotic Surgery?

Robotic surgery is a feasible treatment option for a variety of medical conditions. Robot-assisted surgery is a flexible method that may be used to remove diseased organs such as the appendix as well as cure orthopedic disorders such as carpal tunnel syndrome. Robot-assisted surgery is appropriate for detail-intensive surgeries such as organ repair or artery grafting due to the flexibility and dexterity of the robotic equipment.

Robot-assisted surgery is especially beneficial for more dangerous operations such as head or neck surgery since the robotic surgical tools can readily enter tiny places. In some circumstances, robotic surgery can be utilized instead of traditional surgery as a less intrusive option, allowing the patient to recover faster and with less scars.

Some of the main surgeries robots can perform include:

• Heart surgery: The robotic tools used in robot-assisted surgery may work on the thin, narrow blood veins in the chest cavity without inflicting as much harm as traditional surgery procedures. Robotic surgery's increased accuracy is also beneficial for implanting a device, such as a stent or catheter.
• Joint surgery: Robot-assisted surgery for joint replacement has grown in popularity because it allows doctors to precisely install an artificial joint so that it feels as natural as possible. The new robotic surgery technology, in particular, has improved knee and hip replacement results.
• Gastrointestinal surgery: Robotic equipment can assist surgeons with everything from organ and tissue reconstruction to gallbladder removal. Furthermore, because it allows doctors to remove huge tumors and lymph nodes without making major incisions in the abdomen, robot-assisted surgery provides a minimally invasive approach for stomach malignancies.
• Colorectal surgery: Because colorectal surgery must be conducted inside the limitations of the pelvis, robotic surgery is a helpful technology. A surgeon can efficiently treat various problems in the colon and rectum with the help of robotic devices, including inflammatory bowel disease, colorectal cancer, and hemorrhoids.
• Gynecologic surgery: Because gynecologic treatments are also performed in tiny parts of the pelvis, robot-assisted surgery is a dependable method for treating diseases such as fibroids, ovary and fallopian tube difficulties, and pelvic organ prolapse. Robotic assistance is also useful during hysterectomy surgery, which removes the uterus.
• Prostate surgery: Robotic prostate surgery is frequently used to treat prostate cancer without the discomfort or blood loss associated with open surgery.
• Head and neck surgeries: Robotic surgery is advantageous for accessing tiny parts of the throat and mouth using minimally invasive procedures. Robotic surgery performed through the mouth can aid in the treatment of cancer and other diseases.
• Kidney surgery: Robotic surgery can remove part or all of a kidney that has been damaged by kidney stones, high blood pressure, diabetes, cysts, cancer, or a hereditary issue.

Who Controls Robotic Surgery?

Some patients may be concerned about robotic surgery because they are uncomfortable with the thought of a robot doing surgery. However, the robot never makes any decisions. Throughout the process, the surgeon must instruct the robot on what to perform.

The machine interprets the surgeon's actions in real-time as they steer the control panel, which perfectly mirrors the moves the surgeon performs on the screen within the patient's body, similar to how a video game works. Because the robotic surgical system only reacts to commands from the console, the surgeon maintains total control of the process throughout.

The surgeon, along with other surgical team members, is present in the operating room during the surgery and can walk up to the table at any moment to take over for the robot. Although the extended hours necessary for in-depth surgical operations might induce weariness, robot-assisted surgery allows the surgeon to remain sitting comfortably and easily control the robot's hands, boosting the physician's ability to focus and remain attentive during the operation.

What Can I Expect During Robotic Surgery?

You will be given general anesthesia before to the surgery, which means you will be unconscious and pain-free the whole time. During robotic surgery, the surgeon directs the process from a nearby computer station rather than standing directly over you as in traditional surgery. While each robotic operation is unique, the following are the general steps your surgeon will take:

1. Make tiny incisions in your body so the robotic instruments can fit
2. Insert the miniature robotic surgical instruments and a thin tube attached to a high-definition three-dimensional camera into your body
3. Move to the nearby console, which offers a highly magnified image with excellent resolution of the body’s interior, to direct the procedure
4. Manipulate the controls to carry out the procedure
5. Observe how the robotic instruments respond to their instructions, translating the movements into precise, real-time movements within your body
6. Use the robotic instruments’ greater range of motion and dexterity to successfully complete the surgery
7. Remove the robotic surgical instruments from your body and close up the incision points

After the surgery, you will be sent to a recovery room to recover. Because robotic surgery is a minimally invasive technique, your recovery period will most likely be brief, and you should be able to resume your normal activities soon.

Comparison to traditional methods

Remote surgery, minimally invasive surgery, and unmanned surgery have all made significant breakthroughs thanks to surgical robots. The use of robotics allows for more precision, miniaturization, and smaller incisions, as well as less blood loss, less discomfort, and faster healing time. Articulation beyond typical manipulation, as well as three-dimensional magnification, contribute to increased ergonomics.

These procedures minimize the length of hospital stays, blood loss, transfusions, and the usage of pain medication. The current open surgery procedure has several drawbacks, including limited access to the operative region, a lengthy recovery period, extended hours of operation, blood loss, surgical scars, and markings.

The cost of each unit of the robot ranges from $1 million to $2.5 million, and while its disposable supply cost is generally $1,500 per treatment, the cost of the process is greater. To operate the device, further surgical training is required. Several feasibility studies have been conducted to examine whether purchasing such systems is profitable. As things stand, opinions diverge substantially. Surgeons claim that, while the producers of such devices give training, the learning period is extensive, with surgeons needing to do 150 to 250 operations to become proficient in their usage.

During the training phase, minimally invasive surgeries can take up to twice as long as standard surgery, causing operating room congestion and surgical staffs to keep patients under anesthesia for extended periods of time. According to patient questionnaires, they chose the surgery because they expected lower morbidity, better results, less blood loss, and less discomfort. Higher levels of dissatisfaction and regret may be explained by higher levels of expectations.

What Is the Difference Between Robotic and Laparoscopic Surgery?

While traditional open surgery requires a large incision to be made in order to perform the procedure, both robotic and laparoscopic surgery use smaller incisions through which the surgeon can insert miniature surgical tools and a camera. The pictures obtained by the camera are then used by the surgeon to perform the procedure. Because both robotic and laparoscopic surgery employ fewer incisions, they both provide the benefits of minimally invasive surgery, such as less discomfort, less blood loss, quicker recovery periods, and smaller scars.

Despite its similarities, robotic and laparoscopic surgery have a few major distinctions. During laparoscopic surgery, the surgeon performs on the patient manually, but during robot-assisted surgery, the physician commands the robotic tools remotely from the console.

Laparoscopic surgical instruments have a restricted range of motion, whereas robotic surgery tools are articulated to open and shut as well as spin and twist. Furthermore, traditional laparoscopic surgery employs only one camera, which gives a two-dimensional image. The console used in robotic surgery, on the other hand, creates a high-definition, magnified three-dimensional image that allows the surgeon to see within the patient's body more precisely.

Is Robotic Surgery Better Than Laparoscopic Surgery?

The type of operation determines whether robotic surgery or laparoscopic surgery is the best option. In general, robotic surgery is superior to traditional surgery for working in small, difficult-to-reach places because the surgical tools used in robot-assisted surgery provide the highest level of dexterity. Robotic surgical tools are more flexible than human hands and can spin 360 degrees, allowing the surgeon to be more accurate and reach previously unreachable portions of the patient's body.

Is Robotic Surgery Safe?

Robotic surgery, like any other form of surgery, has possible dangers. Traditional surgery problems, such as infections, excessive blood loss, or organ injury, are considerably reduced with robotic surgery. Here are some typical questions and answers about the safety of robotic surgery to assist you better understand the procedure's minimal risks:

• What is the success rate of robotic surgery: Robotic surgery has a 95% success rate overall.
• What are the risks of robotic surgery: Because robotic surgery provides minimal tactile input, which aids in the prevention of nearby organ damage, the robotic surgical tools may have an effect on the surrounding organs if left unsupervised. However, because a surgeon is continually monitoring and managing the surgery, this danger is considerably decreased.
• Is robotic surgery safer than traditional surgery: While both methods of surgery have a high success rate, having robotic surgery performed by a well trained physician helps reduce blood loss during the minimally invasive process as well as pain and suffering afterward.
• Is robotic surgery painful: According to data obtained from surgery patients, recovery from robotic surgery treatments is less painful than recovery from laparoscopic surgeries.

What are the Concerns of Robotic Surgery?

While robotic surgery has several advantages, it is not always a possibility for all patients. Depending on the sort of operation required, there may be certain downsides to robotic surgery in their particular case. Each patient should speak with their doctor about whether robotic surgery is right for their condition before deciding on a procedure.

Most commonly, robotic surgery is chastised for not delivering adequate haptic input to surgeons, which is a mix of force feedback and tactile feedback that promotes the sensation of touch. Haptic feedback is critical for assisting a surgeon in recognizing and correcting excessive or insufficient force during surgery. Increased haptic input during surgery might allow for better tissue manipulation and less suture breakage.

Another factor to consider when addressing the downsides of robotic surgery is the likelihood of mechanical failure or malfunction. Although mechanical failure and malfunction during robot-assisted surgery are extremely rare, these technological issues are possible. In these circumstances, the surgeon must intervene and perform a different type of surgery, which may need larger incisions, a longer process time, more time under anesthesia, and a longer recovery period for the patient.

What is the Future of Robotic Surgery?

Many types of robot-assisted surgery are being created as the area of robotic surgery continues to expand and progress. Experiments in nanotechnology, for example, have yielded promising results for the future of robotic surgery in terms of increased autonomy and decreased patient intrusiveness. Developing surgical robotic systems, in general, pushes the boundaries of what was previously considered conceivable within robot-assisted surgery, demonstrating that robotic surgery will surely play an essential part in the medical industry for years to come.

Conclusion 

Robotic surgery, also known as robot-assisted surgery, enables surgeons to conduct a wide range of complicated procedures with more accuracy, flexibility, and control than traditional approaches. Robotic surgery is commonly connected with minimally invasive surgery, which is conducted through small incisions.

Robotic surgery can be used to treat cardiac, stomach, bladder, and prostate diseases, among others. Less blood loss, shorter hospital stays, and faster recovery are all advantages. Surgeons who have conducted a large number of these operations often get excellent results.