Howard P. Tay, MD, performs surgery at Banner Thunderbird Medical Center.
Question: Are some surgeries being solely performed by robots?
Answer: Robots are helping surgeons do their jobs better, but they are not replacing them. In robot-assisted surgery, the surgeon sits at a control console not far from the actual operating table. He or she looks into a viewfinder which shows a 3-D image of the surgical site. Using control devices which have sometimes been likened to highly sophisticated joysticks, the surgeon operates three robotic arms that are attached to a workstation next to the patient. One arm holds a camera, and the other two grasp the surgical tools.
Question: What are the benefits of robot-assisted surgery?
Answer: During conventional laparoscopy, the surgeon has to look away from the instruments to a video monitor to see inside the surgical site. The more times he/she has to look away while holding the instruments, the greater the chance that his precision could be compromised. With robotics, the instrument maneuvers are higher in dexterity and complexity. Even better, the robot was designed to alleviate the hand tremor. After hours of surgery, even the best surgeons have had to deal with hand tremors.
Furthermore, robot-assisted surgery is minimally-invasive. Let’s say that in a traditional prostatectomy, the incision is typically 8 to 10 inches long. Using robotics for this same surgery, the patient will have only five-to-six small incisions averaging the diameter of a dime. With such enhanced capabilities, patients will experience reduced trauma to the body, reduced blood loss and the potential need for transfusions, less post-operative pain and discomfort, lower risk for infection, shorter hospital stays, faster recoveries and less scarring.
Other significant advantages of robotic-assisted prostatectomy is the short duration in which a patient has to wear a catheter. Traditional prostatectomy required that the catheter must be left in place for 14-to-21 days while a robotic-assisted prostatectomy patient has to wear a catheter.
With the increase dexterity of the robot as well as the advantage of 3-D optics, a surgeon can perform a much better “nerve-sparing” operation and reduce their patients’ risk of developing erectile dysfunction after their prostatectomy.
Question: Who are the best candidates for robot-assisted surgery?
Answer: The ideal robot-assisted patient is an individual who has not had many abdominal surgeries. Typical abdominal surgeries such as an appendectomy, a cholecystectomy (gallbladder removal), and an inguinal hernia repair do not exclude individuals from having a robotic procedure.
Patients with significant cardiovascular and pulmonary diseases may require an extensive cardiac and medical clearance before they would be consider for robotic surgery.
Ultimately, the decision to move forward will rest upon the surgeon and the patient’s primary care physician.