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    Robotic surgery

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance

    Robotic surgery is a method to perform surgery using very small tools attached to a robotic arm. The surgeon controls the robotic arm with a computer.

    Description

    You will be given general anesthesia so that you are asleep and pain-free.

    The surgeon sits at a computer station and directs the movements of a robot. Small surgical tools are attached to the robot's arms.

    • The surgeon makes small cuts to insert the instruments into your body.
    • A thin tube with a camera attached to the end of it (endoscope) allows the surgeon to view enlarged 3-D images of your body as the surgery is taking place.
    • The robot matches the doctor's hand movements to perform the procedure using the tiny instruments.

    Why the Procedure Is Performed

    Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. The small, precise movements that are possible with this type of surgery give it some advantages over standard endoscopic techniques.

    The surgeon can make small, precise movements using this method. This can allow the surgeon to do a procedure through a small cut that once could be done only with open surgery.

    Once the robotic arm is placed in the abdomen, it is easier for the surgeon to use the surgical tools than with laparoscopic surgery through an endoscope.

    The surgeon can also see the area where the surgery is performed more easily. This method lets the surgeon move in a more comfortable way, as well.

    Robotic surgery can take longer to perform. This is due to the amount of time needed to set up the robot. Also, many hospitals may not have access to this method.

    Robotic surgery may be used for a number of different procedures, including:

    • Coronary artery bypass
    • Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs
    • Gallbladder removal
    • Hip replacement
    • Hysterectomy
    • Kidney removal
    • Kidney transplant
    • Mitral valve repair
    • Pyeloplasty (surgery to correct ureteropelvic junction obstruction)
    • Pyloroplasty
    • Radical prostatectomy
    • Tubal ligation

    Robotic surgery cannot be used for some complex procedures.

    Risks

    The risks for any anesthesia are:

    • Reactions to medications
    • Problems breathing

    The risks for any surgery are:

    • Bleeding
    • Infection

    Robotic surgery has as many risks as open and laparoscopic surgery. However, the risks are different.

    Before the Procedure

    You cannot have any food or fluid for 8 hours before the surgery.

    You may need to cleanse your bowels with an enema or laxative the day before surgery for some types of procedures.

    Stop taking aspirin, blood thinners such as warfarin (Coumadin) or Plavix, anti-inflammatory medications, vitamins, or other supplements 10 days before the procedure.

    After the Procedure

    You will be taken to a recovery room after the procedure. Depending on the type of surgery performed, you may have to stay in the hospital overnight or for a couple of days.

    You should be able to walk within a day after the procedure. How soon you are active will depend on the surgery that was done.

    Avoid heavy lifting or straining until your doctor gives you the OK. Your doctor may tell you not to drive for at least a week.

    Recovery

    Surgical cuts are smaller than with traditional open surgery. Benefits include:

    • Faster recovery
    • Less pain and bleeding
    • Less risk of infection
    • Shorter hospital stay
    • Smaller scars

    References

    Eichel L, McDougall EM, Clayman RV. Fundamentals of laparoscopic and robotic urologic surgery. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 9.

    Fried GM. Emerging technology in surgery: Informatics, electronics, robotics. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 17.

    Oleynikov D. Robotic surgery. Surg Clin N Am. 2008;88:1121-1130.

    Hu JC, Gu X, Lipsitz SR, Barry MJ, D'Amico AV, Weinberg AC, et al. Comparative effectiveness of minimally invasive vs. open radical prostatectomy. JAMA. 2009;302(14):1557-1564.

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                  Review Date: 5/7/2013

                  Reviewed By: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

                  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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