Urology is a medical branch that mainly deals with diagnosing, treating, preventing, and studying conditions related to the urinary system and reproductive organs of your body. The urinary system comprises organs like the urinary tract, kidney, ureter, and urinary bladder. Robotic urology surgery is a technique used by urologists to treat urological conditions via surgeries. It is done to improve the success rate of the surgeries, resulting in improving the overall quality of life of a patient. Furthermore, the experience and outcomes of significant surgeries are enhanced via robotic surgeries. It enables a surgeon to make a tiny incision to access even remote and crucial bodily areas. It is one of the most advanced technologies in modern science, helping both urologists and patients.  

What is robotic urology surgery? 

Robotic urology surgery is a type of minimally invasive urological surgery (MIUS). MIUS helps urologists treat specific conditions without performing open surgery that requires large incisions. MIUS requires small incisions that lead to less damage to healthy tissues. In robotic urological surgeries, urologists mainly use mechanical arms controlled by a surgical console. The arms comprise small surgical instruments at the tip. They also contain cameras to create 3D images, enabling them to view the affected areas more clearly.  

Robotic urology surgeries make use of miniaturised surgical instruments assisted by advanced robots. They mainly aim at smaller and more precise incisions that result in fast recovery, causing less pain to the patients. 

Robotic surgery is performed with the help of specialised robots. The most used robot is the da Vinci robot. The surgical equipment is fixed to the arms of the da Vinci robot and controlled remotely by urologists. Robots recreate the movements of surgeons and prevent the shakiness associated with human hands. Urologists are able to visualise the procedures on a computer/monitor with a stereoscopic visual system that provides a 3D vision.   

How does a robotic system help in urology surgery? 

The robotic system in urology mainly comprises three components: 

• Robotic arms: The tiny hand-shaped arms hold the surgical equipment. They are equipped with small tools and flexible wrists. They provide the urologists with seven degrees of freedom of movement. This flexibility results in more precise and smooth movement during the surgery. They are often referred to as surgical arms. 
• A high-definition camera: This camera enables surgeons to view the surgical area with a 3D vision. 
• Surgical console: It is used to control the robot remotely. It acts as a dashboard for urologists. It helps move the camera to the site they want.  
• Specialised Lens: The surgical system contains a lens responsible for creating magnified 3D images of the surgical site. It results in more visibility and accuracy. 

Surgical procedure  

The robotic urology surgery involves the following procedure performed by urologists with the help of robotic assistance. 

• Initially, surgeons make one or more tiny incisions at the required surgical area after giving anaesthesia to the patient. 
• Through these incisions, a thin tube-like device is connected to the robotic arms. These ports act like temporary tunnels from the surgical instruments. 
• One of the incisions is attached with a flexible camera called an endoscope to get high-definition 3D images during the procedure.  
• Then, the robotic devices are attached to the ports, and instruments are placed in them. 
• Then, urologists precisely control the robotic arm’s movements while sitting at a console a few feet away from the patient. However, the assistants remain by the side of the patients to help adjust the instruments as needed.  
• After performing the surgery, urologists remove all surgical instruments and ports. 
• Then, the incisions are closed via stitches.  

Robotic urology surgery plays a crucial role in various surgeries, such as: 

• Robotic prostatectomy: Surgery that involves the removal of prostate glands with the help of robotic assistance 
• Robotic cystectomy: Surgery that involves removal of the urinary bladder 
• Robotic partial nephrectomy: Surgery that involves the removal of tumor in the kidney  
• Robotic pyeloplasty: Surgery used to treat the ureteropelvic junction, which blocks the flow of urine from the kidney to the bladder 
• Kidney transplantation: Surgery used to replace a damaged kidney with a healthy one from a donor 
• Ureteric reimplantation 
• Nephroureterectomy 

Benefits of robotic surgery in urology 

Robotic urology surgery confers many benefits to both urologists and patients in treating various urological disorders. 

Patient’s benefits: 

• It involves a lower risk of infections that are likely to emerge after the surgery. 
• It causes less pain and discomfort to the patients. 
• This results in a quick recovery time for the patients. 
• It results in reduced blood loss. 
• As the recovery time is enhanced, it allows a shorter hospital to stay. 
• It causes smaller scars compared to open surgeries. 

Surgeon’s benefits: 

• The robotic arm’s movement results in a greater range of motion than the surgeon’s hand. This enables the surgeons to rotate the instruments more flexibly, even in tight spaces.  
• The specialized camera and lens provide high-resolution 3D images that enable surgeons to get a more precise view of the surgical area.  
• The small incisions with instruments allow surgeons to carry out the surgery in less duration.  

Conditions requiring robotic-assisted surgery 

Congenital nephrotic syndrome 

This condition affects infants and children. It causes end-stage renal disease, which is kidney failure. It is caused by the inability of kidneys to filter waste products from the blood. The signs and symptoms include proteinuria, hypercholesterolemia, ascites, swelling, and hematuria. 

Alport syndrome 

It is a genetic condition caused by an insufficient production of IV collagen proteins by the kidney. Type IV collagen is a protein of the filtration membrane called glomerular basement membrane (GBM). It is a three-layer membrane that filters the blood. It prevents other products, like blood cells and proteins, from entering the urine. GBM leads to Alport syndrome is caused. As type IV collagen is also present in ears and eyes, this condition also affects vision and hearing, along with kidney failure.  

Polycystic kidney disease 

It is a condition where cysts develop in the kidneys. It is a chronic condition wherein cysts enlarge over time, preventing the kidney from filtering waste from the blood, leading to kidney failure. It is caused by genetic mutations. The symptoms include headache, hematuria, abdomen pain, and high blood pressure.  

Glomerulonephritis 

It is a condition where glomeruli inside the kidneys are damaged, leading to kidney failures. It can be acute or chronic. The symptoms include haematuria, nausea, abdomen pain, and swelling of the legs. 

Prostate cancer 

The prostate is a small walnut-shaped gland that secretes hormones. When the tumour is developed in the prostate gland, prostate cancer is caused. The other types of prostate cancers involve: 

• Small cell carcinoma 
• Transitional cell carcinoma 
• Sarcomas 
• Adenocarcinoma  

The symptoms include: 

• Frequent urination 
• Loss of bladder control 
• Painful erectile dysfunction 
• Loss of bowel control 
• Haematospermia 
• Pain in abdomen 

Kidney cancer 

Kidney cancer is a condition characterised by abnormal growth of cells in the kidney tissue, causing tumours. These tumours gradually spread to other tissues and organs. Different types of kidney cancers include:  

• Renal cell carcinoma  
• Transitional cell carcinoma 
• Renal sarcoma 
• Wilms tumour 

The signs and symptoms include:  

• Haematuria 
• Flank pain 
• Weight loss 
• Fatigue 
• Lump near the kidney area 
• Fever 

Bladder cancer 

Bladder cancer is a condition wherein abnormal cells develop in the lining of the bladder. The bladder is a hollow tube that stores urine. There are many types of bladder cancers, such as: 

• Transitional cell carcinoma 
• Squamous cell carcinoma 
• Adenocarcinoma 

How does a robotic urology surgeon guide you? 

A robotic urology surgeon provides you with all the necessary information and preparation for the surgery beforehand. Along with that, the surgeon will guide you in the following ways:  

• Robotic urology surgeons will make small and more precise incisions, which greatly reduces the complications post-surgery.  
• The robotic arms controlled by a robotic urology surgeon allow for fine and steady movements far beyond human capabilities, thus reducing error during the surgery.  
• The small and accurate incisions allow minimal tissue damage and ensure a faster recovery.  
• The robotic urology surgeon, through minimally invasive procedures, offers you less pain and discomfort compared to traditional open surgeries.  
• The robotic procedures profoundly enhance the visuality, which could be designed to be viewed in 3D. This allows for better identification and understanding of the anatomy for precise cuts and repairs.  
• The hand movements of a robotic urology surgeon are mimicked in the human body through the robotic hands. This phenomenon allows for greater precision and accuracy, which can contribute to enhanced outcomes.  
• This also allows a robotic urology surgeon to reach places that are difficult to reach traditionally.  
• Robotic urology surgeons often tailor the approach to each individual, ensuring the personalisation of the therapy. This significantly improves surgical outcomes and substantially decreases complications post-surgery.  
• Also, it decreases the length of hospital stay and infections, thus again contributing to improved post-surgical outcomes compared to the conventional surgical approach.  

By educating you with all the above advantages, a robotic urology surgeon will explain the entire procedure along with the outcomes and consequences. Surgeons help you recover faster and with less pain.  

How team Fortis helps you during a robotic urology surgery? 

Team Fortis will support you throughout the procedure and stay at the hospital with state-of-the-art facilities. Here’s how.  

• At Fortis Hospital, we have highly experienced surgeons who have performed hundreds of robotic urology surgeries. Their extensive experience and expertise speak about their success in the field of robotic surgeries. Our surgeons have performed various robotic surgeries, including, but not limited to, kidney cancers, prostate cancers, kidney stones, bladder obstructions, and many more.  
• Fortis Hospital is one of the best urology hospitals in India, equipped with advanced and sophisticated robotic surgery equipment. This allows for enhanced precision, flexibility, and control over the surgeries. This enables the surgeons to perform complicated surgeries without difficulties, allowing less time for recovery and offering reduced pain post-surgery.  
• At Fortis, we have a well-versed pre-surgical support team. You will be assured of the success of the surgery, along with proper and efficient counselling. All your doubts and queries will be answered seamlessly, and you will be given sufficient time to discuss them with the surgeons. You will be guided throughout each and every step of your stay at Fortis.  
• Fortis adopts a multidisciplinary approach, where doctors and surgeons from different departments will be involved in decision-making, ensuring patient-focused treatment. All your problems will be addressed before the surgery. Pre-anaesthetic evaluation and general medicine fitness will be carried out before your surgery to assess your fitness.  
• During the surgery, we will be there for your family, ensuring mental and emotional support.  
• After the surgery, a team of surgeons, doctors, nurses, and dieticians will take care of you.  
• Our doctors will provide post-operative pain management and make you comfortable during the stay.  
• Post-surgery, Fortis Healthcare will set regular appointments for your follow-up till your complete recovery.  
• Fortis is committed to providing a patient-centric approach to treating urology conditions using robotic surgeries.   

With Fortis, you can expect high standards and comprehensive treatments at each step of your robotic urology surgeries.  

Conclusion 

All things considered, robotic urology surgery provides a less invasive method for handling complex urological surgical procedures with decreased risk of complications, less pain, shortened hospital stay, and increased precision to help you recover as quickly as possible. At Fortis, we take care of your urological condition with a personalised approach.