Robotic Surgery – Making Surgery Safe and Precise
Robotic surgery is essentially a robot assisted laparoscopic surgery. Laparoscopic surgery is also commonly referred to as keyhole surgery. We shifted from the traditional open surgeries to laparoscopic surgeries in the past 30 years or so. Soon we, as surgeons, realized that although laparoscopic surgeries made recovery of patients faster with minimal scarring, they had some limitations in performing advanced surgeries. This was especially true for surgeries that required fine dissection and fine suturing. The limitations were straight tipped instruments and a two dimensional view.
Soon, these limitations were overcome with the advent of the surgical robot in the early 2000s. The robotically controlled instruments have a “wrist” just like human hand. This allows for greater degree of freedom of movement of instrument tip while it is inside. In robotic surgery, the instruments can be inserted via small access tubes inserted into the abdomen called “ports”. These instruments are then connected to the patient cart portion of the robot. These instruments once placed are locked at that point. They are then moved and manipulated using the surgeons’ console placed in the operation theater close to the operating table. The operating surgeon while looking via the 3D viewer does the surgery. To see inside the patient’s abdomen, a 3 dimensional camera is employed. This again is passed via one of the ports.
The advantage of having endowristed instruments in robotic surgery provides ease of manipulation and greater precision. Since these instruments are controlled robotically, there is practically no tremor. Hence, those surgeries requiring precise dissection and suturing are done in a much better way. This results in improved patient outcomes with minimal scars. There are fewer stitches and minimal pain. Patients get an early discharge and can start normal life very soon.
The robot deployed in a robotic surgery has built in safety features. The moment the surgeon takes his head off the console for some reason, the instruments freeze at that position itself, thus minimizing the chances of inadvertent injury. If there is a malfunction of the instrument, the instrument stops functioning and gives an indication. The data regarding the malfunction is immediately sent to the manufacturer of da Vinci robotic system over the internet and the fault is rectified.
Move over big incisions for surgeries, for the new robotic technology is here, and it is here to stay. It is a matter of time before the robot is used for almost every surgery.
Authored by:
Dr Manish Ahuja
Consultant, Urology
Fortis Hospital Mohali
