Where is Robotic Surgery Used?

Robotic surgery can be used in the surgical treatment of diseases belonging to many different specialties such as general surgery, urology, gynecology, cardiovascular diseases, pediatric surgery and otolaryngology.

Is the Robot doing the Surgery?

Of course, NO. The name 'Robot' seems interesting. It is often thought that the robot performs the surgery. It's not a robot doing the surgery, it's a surgeon. In robotic surgery, the surgeon commands the robot, and the arms on the patient console perform the operation by simultaneously reflecting all the commands received from the surgeon.

What is Robotic Surgery?

Robotic surgery, also known as da Vinci robotic surgery system, is the most advanced state of minimally invasive surgery. The da Vinci robot, which is the only example of robotic surgery systems in the world, consists of 3 main parts: surgeon console, patient console and display tower. Instruction from the surgeon console are transferred to the Da Vinci robot located on the patient console. The da Vinci robot is dressed in a sterile special sheath. As in laparoscopic surgeries, incisions are made from the abdominal wall according to the operation to be performed, and instruments that allow the hand tools called trocars to easily enter and move into the abdomen are inserted. According to the operation to be performed, the 3D imaging system is entered from the appropriate trocar. Since the imaging device is robot-controlled, it does not vibrate and the surgeon has a realistic three-dimensional vision. Since the optical system is high resolution and the image is transmitted by fiber optic cameras, there is no image loss even if the image is zoomed in. The surgeon can provide better than normal field of view images in narrow spaces and depths. Then, the hand tools required for the surgery to be performed from other trocars are entered. Robotic console connection is provided with hand tools. The surgeon sits on the surgeon console and manages the robotic console movements with hand movements. Robotic arms, which have a rotation angle of 720 degrees, allow movements that are not possible for human hands to be made easily. Small tremors in the surgeon's hands are not reflected in robot-controlled surgical instruments. Thus, the margin of error that can be experienced in surgery is reduced to the lowest possible level.  

Robotic Surgery in General Surgery

Robotic surgery can be used in most of the General Surgery operations.
Large intestine and rectum surgery, especially in rectum surgery, increases the mobility in the narrow area in the pelvis.
Obesity and metabolic surgery (Diabetes surgeries); It provides guidance of the intestines and comfortable anastomosis in the abdomen in diabetes surgeries.
Liver resections – hepatectomy, segmentectomy; With a wider viewing angle, it allows the bile ducts and blood vessels in the liver to be seen more easily and allows surgery to be performed with less complications and bleeding.
Whipple surgery for pancreatic cancer, total pancreatectomy and distal pancreatectomy, especially in whipple surgery, provide easier manipulation of the anastomosis between the pancreatic duct and newly formed pathways between the biliary tract and the small intestine.

Stomach and esophageal cancer surgery

Robotic Surgery in Urology

Urology is one of the departments where robotic surgery is used most frequently.
Prostate cancer surgery; The mobility in the narrow pelvis increases with robotic surgery, the nerves close to the prostate are protected with clearer vision, so problems such as erection and urinary incontinence are much less common after the operation.
Kidney surgeries-kidney cancer, urinary tract stricture surgeries; In kidney cancer, in the surgery of removing the kidney completely or partially, the vessels feeding the kidney are freed and the mobility is high. It minimizes the risk of possible complications.

Robotic Surgery in Gynecology

Gynecological surgeries are mostly performed in a narrow area in the inner part of the pelvis, just like urological surgeries. Robotic surgery provides increased mobility in this narrow space. 
Gynecological cancer surgeries; Especially in these surgeries, if the lymph nodes to be performed if necessary are cleaned, it allows the protection of both vessels and nerves easily.
Myomectomy Surgeries
Uterine prolapse surgeries; It facilitates the release of a part of the vagina in the deep pelvis and the detection of the patch used if preferred.

Robotic Surgery in Cardivascular Surgery

  • Coronary bypass surgeries
  • Rhythm disturbances
  • Heart valve surgeries

Robotic Surgery in Otorhinolaryngology and Head and Throat Surgery

In the surgery of tumors and cysts in the larynx, pharynx, tonsils, tongue and mouth, no incision is made on the patient's skin. It is made with incisions made inside the mouth and is called transoral robotic surgery. In these surgeries, 2-armed robots are used rather than 4-armed robots.

Advantages of Robotic Surgery

Robotic surgery technology has many benefits that can be counted as it makes it easy to perform many complex surgical procedures together. 
The robotic surgery system, which performs surgical operations with a small incision, is in favor of the patient as it provides less trauma and pain in the patient's body, minimal scarring, shorter hospital stay and faster recovery time. It causes less wound infection.

Another situation that can be counted among the advantages of robotic surgery is the use of robotic arms that can imitate the movements of the hands and have an articulated structure. It offers more dexterity and precision than is possible when compared to traditional methods. Robotic arms can rotate at an angle of 720 degrees and do not vibrate.
The use of high-resolution 3D cameras in robotic surgery allows surgeons to see closely areas that they normally cannot see with the naked eye. The normally seen image can be magnified 10 times without loss of image. This means that the surgeon dominates more areas and sees the operation in all its fine details.

The doctor gets tired less because she/he works sitting down. Thus, during long-lasting operations, the stress level of the physician decreases while the concentration level increases.

Şadan AY, MD
Orthopedics and Traumatology
Medicana International Ankara
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Created at 11.10.2023 06:21
Updated at 29.10.2023 08:05
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