I am often asked what I do while the robot is operating. Someday I may be able to enjoy my coffee while a robotic is doing the work, but not today! Robotic surgery is actually robotic assisted surgery. The primary surgeon is still controlling everything that happens during an operation. However instead of directly handling a scalpel or scissors they are controlling this electronically with robotic assistance. Much like changes in our automobiles over the past decades. Our steering wheels were recently directly connected the the wheels by gearing. Now turning the steering wheel is just data perceived and acted on by our car’s computer.
Robotic surgery was originally developed for two reasons. One was to see if a mechanism could be developed to allow surgeons to have the ability to operate remote at multiple locations such as near a battlefield with mobile outposts. The other was to improve upon the evolving technique of laparoscopy. This was developed to allow instruments to be used inside a person’s body and perform and operation with only these small incisions. This was limited however as traditional laparoscopic instruments had limited movements once inside. The addition of robotic control changed these ‘sticks’ to ‘hands’ allowing all the instruments to function like a wristed hand. This allowed minimally invasive approaches to be used for much more complicated procedures.
Robotic assistance has a definite advantage anytime a surgery is complicated or requires reconstruction. This is because the wristed instruments make dissection, sewing, and reconstruction much more facile. In my experience I have valued this in procedures such as:
There has been much press recently about the dangers of robotic surgery. In reality the robot is just a tool used during surgery. The safety of this tool is dependent on the surgeon’s experience, the appropriateness of the procedure for a minimally invasive approach, and the difficulty of the case. All surgery has risk and a thorough discussion of the different options and risks is extremely important before proceeding with any surgery. However in my experience having a robotic option available has been a wonderful addition for my patients, as a more minimally invasive approach can significantly improve recovery after surgery.
Choosing a surgeon is a big decision. It is always important that you trust your surgeon and feel a good rapport with that person. Their first job is helping you understand your disease and then giving you good information for you to make the best treatment decision for you. Once you are comfortable with your plan it is important that you ask about their personal experience and outcomes with previous patients. Do not be afraid to ask questions or ask for specifics. Good questions include number of similar case, average surgical time, etc, margin rates. Not all surgeons have similar outcomes or take the time to know their specific data and these are very important data for you. You will do better the more comfortable with everything about the process.