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Robotic Surgery

What is Robotic Surgery

Robot-assisted surgery enhances the capabilities of traditional laparoscopic (keyhole) surgery.

 

It facilitates minimally invasive surgery especially in areas that are traditionally considered too difficult for conventional laparoscopy (e.g. pelvic surgery, liver/ pancreas surgery).

 

The technology has in-built features allowing for precise movements and enhanced views (see below).

 

The robot consists of:

 

  • Surgical arms with small instruments that have wristed arms. Each arm is attached to the patient via a port requiring an 8mm incision (thus often smaller than laparoscopy).
  • Camera that provides enhanced, magnified 3D views (unlike 2D laparoscopy)
  • Surgical console where the surgeon takes control of the instruments and performs the operation.

How is robotic surgery different from traditional, open surgery?

The specifics of each operation remain the same but instead of a large incision, the operation is done via smaller incisions and minimally invasive means. Since the instruments themselves are smaller, there is less tissue handling overall.

 

 

Ports are placed into the abdomen similar to laparoscopy but the robotic arms are attached to the ports and the surgeon controls the robotic arm while sitting at the console. There is always an assistant by the bedside.

 

 

Who performs robotic surgery?

A specialist surgeon performs robotic surgery in their field of training. i.e. a robotic liver resection is performed by a Hepatobiliary Surgeon with Robotic Fellowship training.

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What are the benefits of robotic surgery for the patient?

Depending on the procedure, robotic surgery is associated with:

  • Less pain during recovery
  • Lower risk of infection
  • Reduced blood loss
  • Shorter hospital stay
  • Smaller scars
 

Disadvantages of robotic surgery

  • Greater cost of consumables
  • Longer operating time (this is often offset by decreased hospital stay)
 

What types of robotic-assisted surgery are available?

Robotic surgery is appropriate for many types of procedures. 

 

Currently in New Zealand, it is used in the fields of General Surgery (Ventral Hernia, Liver and Pancreas resection), Urology, and Gynaecology. This is likely to increase in the future.

Frequently Asked Questions
  • 01 Does the robot perform the surgery itself?

  • 02 Why don’t they use the robot all the time?

    For many operations, conventional laparoscopy or an open operation remain appropriate. In these situations (e.g. routine cholecystectomy), the technological advantages of the robot don’t confer added benefit to the patient.

  • 03 Does the robot guarantee a minimally invasive operation?

    Although there is evidence that the robot leads to a lower risk of conversion to open when compared to conventional laparoscopy, there is always a chance that surgery is safest via an open incision requiring intraoperative “conversion to open”. Most surgeons would see this as a necessity for their patient’s welfare rather than a ‘failure’.

  • 04 Doesn’t open surgery provide the most direct, best view?

    The robotic camera provides real-time, high-resolution, magnified images with 3D capabilities and zoom that surpasses the human eye. Thus, the robotic view is in fact superior to open surgery.

  • 05 Can I just have the operation laparoscopically instead of robotically?

    In many cases, this is completely appropriate. However, in specific fields in general surgery (e.g. ventral hernia, liver and pancreas resection) and in other branches of surgery (e.g. radical prostatectomy in urology), the robotic approach has been shown to be superior to both laparoscopic and open surgery.

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