Robot-assisted surgery
Its benefits, risks, recovery and cost

Robotic surgery – How robotics is changing the patient experience in this fast paced world?

The 1990s saw a revolution in the world of surgery with the advent of Laparoscopy. Laparoscopy is a minimally invasive surgery improved the aesthetic outcomes of the major surgery with a comparatively smaller scar as against a long incision scar from open surgery. Robotic surgical systems were still in pipeline and under investigation then.

Over the years, robotic surgical systems have evolved and through extensive research and testing. In the year 2000, for the first time, USFDA approved the clinical use of these systems in surgeries. As with any new technology, robotics is slowly moving into the realm of surgery

The word “surgery” may bring apprehensions to the mind of many of us. Constantly lingering thoughts about the chances of success of the surgery, time to recovery and returning to the routine are hard to deal with. With the advances in robotics and surgical technology, one can now expect a very different surgery experience.

What is minimally invasive surgery (MIS)?

A surgery that is carried out with smaller incisions (cuts) instead of the larger incisions of the traditional open surgery is called minimally invasive surgery. MIS makes use of thin-needles and a tube fitted with a camera at the end called endoscope to visually guide the surgery. The most important benefit of MIS is shorter hospitalization and faster recovery time. Additionally, the benefits may be:

• Less amount of blood loss
• Less scarring due to a decrease in the size of the incision
• Reduced chances of infection

What is Robotic Surgery?

The earlier techniques of MIS had some limitations due to certain constraints. The advanced technology, known as robotic surgery or computer-assisted surgery was developed primarily to overcome the constraints and issues associated with minimally invasive surgery. It makes use of small tools attached to a robotic arm that is controlled and operated through a computer by a surgeon to enhance the capabilities of performing the minimally invasive surgery.

How does a robot-assisted surgical system function?

During a robotic surgery, the surgeon will make small incisions in the body through which small surgical instruments and a three-dimensional, high definition camera is inserted. These instruments are then manipulated from a computer console to perform the operation. The difference here is that the surgeon does not stand over the patient’s body like traditional surgery. The instruments translate the movement of the surgeon’s fingers into precise and real-time movements inside the body. All this while, the surgeon is in control and the surgical system responds to his directions.

How does a robot-assisted surgical system function?

While some patients may be concerned about the idea of a robot performing surgery on them, one thing that is reiterated is that a robotic surgery actually just facilitates the surgeon in making more precise and delicate movements than the human hand. The decisions while performing the surgery are taken by the surgeon and the system cannot “think” on its own. It’s the surgeon who directs the procedure the entire time.

What are the benefits of robot-assisted surgery?

Robot-assisted surgery offers many benefits over the conventional surgery. Some of these benefits are:

• It provides a better range of motion and dexterity to the surgeon
• It gives a highly-magnified and a high-resolution image of the operating field
• The surgeon gets better access to the area being operated on
• It helps reduce the hospital length of stay
• Reduced risk of infection
• Lesser blood loss and need for fewer blood transfusions
• Less pain
• Faster recovery
• Early return to daily routine

What are the risks of robotic surgery?

Robot-assisted surgery involves risks specific to the procedure, although relatively rare and minor such as –

• Damage to structures surrounding the operated area.
• Development of a hernia due to the small surgical incisions, known as ‘port site hernia’.
• Post-surgical infection.
• Life-threatening risks and complications are negligible.

What are the indications of robotic surgery?

Robot-assisted surgery is finding applicability across multiple specialties in medicine due to its benefits and improved surgical outcomes. Some of these applications include:

• Urologic Surgery – Prostrate Surgery
• Bariatrics (Weight Loss Surgery)
• Cardiac Surgery
• Cardiothoracic Surgery
• Colorectal Surgery
• Gynecologic Surgery like Hysterectomy
• Head & Neck, Transoral Surgery
• Cancer Surgery
• Otolaryngology, Head & Neck (ENT)
• Reproductive Endocrinology & Infertility
• Thoracic Surgery
• Transplant Surgery like Kidney (Renal) Transplant
• Eye Surgeries like Cataract, Cataract Surgery with Femto Laser

However, like any other surgery, many factors are taken into consideration to decide the best surgical approach. A consultation with doctor will help to determine whether robotic surgery is beneficial in a particular case.

What are the indications of robotic surgery?

Can robotic surgery be performed by any doctor?

Surgeons who perform robot-assisted surgeries need to undergo special training on handling the robotic system and the techniques of robotic surgery. Robotic sciences department includes a multidisciplinary team of doctors and surgeons who are trained and specialized in expertly handling the robotic systems.

How much time does a patient take to return to routine life after robotic surgery?

Every patient is different and recovery depends on a multitude of factors like the complexity of the disease, underlying medical conditions and systemic health of the patient. However, in general, patients may have to stay for two-three days in the hospital after the surgery and then return home. Compared to traditional surgery, robotic surgery helps patients to heal faster as the procedure precisely handles the operation area with smaller incisions, a limited risk of infection, blood loss and other complications. Thus, robotic surgery offers reduced hospital stay and patients return to normal routine sooner. Most patients recover and return to normal life within six weeks of surgery.

What factors govern the cost of robotic surgery?

Given that there are only about 4000-5000 robotic surgery centers in the world, the treatment is currently available only in limited centers in India. The cost of infrastructure, import of equipment, technical know-how and maintenance of equipment contribute to the treatment costs.

The cost of surgery also depends on a multitude of other factors like:

• Experience and expertise of the transplant surgeon and team.
• Surgery facilities and equipment.
• Underlying co-morbidities and age of the patient which may affect the – number of days stay in the hospital, additional tests and medicine requirement.

To know more about robotic surgery, you can request a call back and our robotic surgery specialist will call you and answer all your queries.

References:

• Mayo Clinic. Robotic surgery. Available at:https://www.mayoclinic.org/tests-procedures/robotic-surgery/about/pac-20394974. Accessed on April 12, 2018.
• Robotic surgery. Available at: https://medlineplus.gov/ency/article/007339.htm. Accessed on April 12, 2018
• Annals of surgery. Robotic Surgery, A Current Perspective. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356187. Accessed on April 12, 2018

Disclaimer:

“The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”