The Medical Minute: Robotic surgery -- the future is here
(PhysOrg.com) -- The goal of all surgical intervention is to allow patients to have a procedure completed in the best way that will optimize and improve their health. One of the emerging methods to achieve decreased pain with surgery, minimal blood loss, fewer complications, shorter hospital stay, faster return to activities of daily living and improved patient satisfaction is through minimally invasive surgical techniques. The idea of minimally invasive surgery is to be able to perform many types of surgical procedures through small incisions. Robotic technology is one way that we are accomplishing this goal. Additionally, complex procedures can now be performed with a minimally invasive approach through skilled surgeons using robotic technology; all accomplished with an outpatient or short hospital stay.
The first robotic procedure occurred in 1985 when a robot was used to place a needle for a brain biopsy. Since that time, much progress has been made in robotic technology, and today at Penn State Milton S. Hershey Medical Center we have the latest version of the FDA-approved robotics equipment called the da Vinci Si. The da Vinci robot was named as such in part because Leonardo da Vinci invented the first robot. The da Vinci robot has been utilized to perform gynecologic, urologic, cardiothoracic and other general surgery procedures.
Listed below are examples of areas in which robotic technology is emerging (to name a few):
Gynecology: Uterine fibroids, hysterectomy, gynecologic cancers (lymph node sampling), endometriosis, ovarian cysts, tubal reversal and vaginal prolapse.
Cardiothoracic: Heart valves, coronary artery bypass, surgery on the heart, lungs or esophagus.
Urology: Prostate cancer, bladder cancer and kidney disorders.
General surgery: Colorectal cancer and bowel disease.
The da Vinci Surgical System comprises three components: a surgeon’s console, a patient-side robotic cart with four arms manipulated by the surgeon (one to control the camera and three to move instruments), and a high-definition 3D vision system. The difference with the robotic system compared to traditional laparoscopy or open surgical procedures is that small surgical instruments mounted on the robotic arms can move just like the surgeons' hands, but without having to have a large incision through which to work. In comparison, the instruments with standard laparoscopy are rigid and do not involve “wristed” instruments. The robot filters out tremor and provides a truly 3D image to the surgeon (also unlike regular laparoscopy). It is thought that precision and dexterity are key enhancements of robotic-assisted surgery.
All of these advancements may help to improve a surgeon’s outcomes. The surgeon, seated at the console, always is in control of the arms of the robot and the robot is not acting independently to perform the surgery but is maximizing the attributes of the surgeon. The surgeon always visualizes the real time image of the patient, and there is no virtual reality involved in the robotic surgery.
Each patient will need to discuss with their surgeon if robotic surgery is appropriate for them. The field is developing rapidly, and the robotic surgery team at Penn State Hershey Medical Center will continue to follow its progress as more information becomes available on the experience with this new technology.
Provided by Penn State
