Robotic surgery

Robotic surgery is the minimally invasive surgery performed with the help of a robotic surgical system. It was developed in the last decade to overcome the limitations of the minimally invasive surgery. It gives the possibility to operate with higher precision, to use finer and more flexible instruments than those used in laparoscopic surgery, to have a 360-rotation movement that the human wrist does not have and absolute view with a three-dimensional enlarged image, and the possibility to preplan an operation, access inaccessible or microscopic areas on which hitherto surgeons did not dare operate, and perform remote surgery, which was the springboard for the development of robotic surgery.

While maintaining the advantages offered to patients by the minimally-invasive surgery (endoscopy, laparoscopy), robotic surgery may be applied to many operations and prove to be a valuable tool in the hands of surgeons of many specialties: general surgeons, thoracic surgeons, heart surgeons, gynecologists, urologists, vascular surgeons, pediatric surgeons and bariatric surgeons.

Especially for the mixed bariatric operations, robotic systems are superior to all other methods since sutures and inosculations are performed with maximum precision, which results in the patient’s faster recovery.

Moreover, surgeons no longer have to stand throughout the surgery, so they do not tire as quickly, especially in long operations.

As to the cost of a robotically assisted surgery, it must be clarified that even though the cost of the operation per se is higher than the one of other methods due to the high purchase price of the system and the cost of the materials per operation, on the whole the cost of the operation may prove to be lower because patients recover faster, the time of hospital stay is reduced and postoperative complications are minimal.

A robotic surgery is performed by a surgeon who sits on a surgical console and handles the articulated arms of a robot with the help of a computer and special levers. Commands are digitally transferred on the robotic arms in real time, which execute the moves on the patient's body with the highest precision through 3-4 small incisions. The skillful handling of the robot is the outcome of the surgeon’s special training; he gradually becomes bimanual and may handle at the same time more instruments than he could in an open surgery.

The best system robotic surgery has to show is the Da Vinci Surgical System that consists of:

» the surgeon’s console, which has a high definition monitor to display three-dimension images transmitted by an endoscopic camera. The camera is operated by special levers (master controls) and pedals and the system is also equipped with a three-dimensional display lens system able to enlarge images up to 15 times. Surgeon’s commands are fixed by a software and then transmitted to the arms.

» the basic system with the 4 robotic arms on which are adapted particularly flexible surgical tools to facilitate the surgeon's work.

» and the endoscopic tower that includes a large screen and the robot’s support tools.

Robotic surgery overcomes the human weaknesses of surgeons, perfects laparoscopic surgical method and it is estimated that in the future it will be the dominant method in complex and long-hour surgical procedures.