Robotic Surgery

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:

• Coronary artery bypass
• Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs
• Gallbladder removal
• Hip replacement
• Hysterectomy
• Kidney removal
• Kidney transplant
• Mitral valve repair
• Pyeloplasty (surgery to correct ureteropelvic junction obstruction)
• Pyloroplasty
• Radical prostatectomy
• Radical cystectomy
• Tubal ligation

Robotic surgery cannot be used for some complex procedures.

Risks

The risks for any anesthesia and surgery include:

• Reactions to medicines
• Breathing problems
• Bleeding
• Infection

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 medicines, 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.

Outlook (Prognosis)

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

Eichel L, McDougall EM, Clayman RV. Fundamentals of laparoscopic and robotic urologic surgery. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 9.

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: Elsevier Saunders; 2012:chap 17.

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):1557-64. PMID: 19826025 www.ncbi.nlm.nih.gov/pubmed/19826025.

Oleynikov D. Robotic surgery. Surg Clin N Am. 2008;88:1121-30. PMID: 18790158 www.ncbi.nlm.nih.gov/pubmed/18790158.