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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Robotic surgery

Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance

Last reviewed: May 7, 2013.

Robotic surgery is a method to perform surgery using very small tools attached to a robotic arm. The surgeon controls the robotic arm with a computer.

Description

You will be given general anesthesia so that you are asleep and pain-free.

The surgeon sits at a computer station and directs the movements of a robot. Small surgical tools are attached to the robot's arms.

  • The surgeon makes small cuts to insert the instruments into your body.
  • A thin tube with a camera attached to the end of it (endoscope) allows the surgeon to view enlarged 3-D images of your body as the surgery is taking place.
  • The robot matches the doctor's hand movements to perform the procedure using the tiny instruments.

Why the Procedure Is Performed

Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. The small, precise movements that are possible with this type of surgery give it some advantages over standard endoscopic techniques.

The surgeon can make small, precise movements using this method. This can allow the surgeon to do a procedure through a small cut that once could be done only with open surgery.

Once the robotic arm is placed in the abdomen, it is easier for the surgeon to use the surgical tools than with laparoscopic surgery through an endoscope.

The surgeon can also see the area where the surgery is performed more easily. This method lets the surgeon move in a more comfortable way, as well.

Robotic surgery can take longer to perform. This is due to the amount of time needed to set up the robot. Also, many hospitals may not have access to this method.

Robotic surgery may be used for a number of different procedures, including:

Robotic surgery cannot be used for some complex procedures.

Risks

The risks for any anesthesia are:

  • Reactions to medications
  • Problems breathing

The risks for any surgery are:

Robotic surgery has as many risks as open and laparoscopic surgery. However, the risks are different.

Before the Procedure

You cannot have any food or fluid for 8 hours before the surgery.

You may need to cleanse your bowels with an enema or laxative the day before surgery for some types of procedures.

Stop taking aspirin, blood thinners such as warfarin (Coumadin) or Plavix, anti-inflammatory medications, vitamins, or other supplements 10 days before the procedure.

After the Procedure

You will be taken to a recovery room after the procedure. Depending on the type of surgery performed, you may have to stay in the hospital overnight or for a couple of days.

You should be able to walk within a day after the procedure. How soon you are active will depend on the surgery that was done.

Avoid heavy lifting or straining until your doctor gives you the OK. Your doctor may tell you not to drive for at least a week.

Convalescence

Surgical cuts are smaller than with traditional open surgery. Benefits include:

  • Faster recovery
  • Less pain and bleeding
  • Less risk of infection
  • Shorter hospital stay
  • Smaller scars

References

  1. Eichel L, McDougall EM, Clayman RV. Fundamentals of laparoscopic and robotic urologic surgery. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 9.
  2. Fried GM. Emerging technology in surgery: Informatics, electronics, robotics. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 17.
  3. Oleynikov D. Robotic surgery. Surg Clin N Am. 2008;88:1121-1130. [PubMed: 18790158]
  4. Hu JC, Gu X, Lipsitz SR, Barry MJ, D'Amico AV, Weinberg AC, et al. Comparative effectiveness of minimally invasive vs. open radical prostatectomy. JAMA. 2009;302(14):1557-1564. [PubMed: 19826025]

Review Date: 5/7/2013.

Reviewed by: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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What works?

  • Robotic assisted surgery for gynaecological cancerRobotic assisted surgery for gynaecological cancer
    In recent years, robotic surgery or robot assisted surgery has been developed to support a range of surgical procedures. Robotic surgery in cervical and endometrial cancer is one of the fastest growing areas. Major advances aided by surgical robots are being made via remote surgery, keyhole (laparoscopic) surgery and unmanned surgery. It is hypothesised that robotic surgery may result in reduced blood loss, favourable complication rates and short hospital stays. However, the review authors found no RCTs to support or refute the use of robotic assisted surgery for gynaecological cancer. Evidence from controlled clinical trials offers very little credibility as these studies present a high risk of bias.
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