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What is robotic surgery?

Robotic surgery, also known as robot-assisted surgery, is a modern surgical technique that involves the use of robotic systems to perform minimally invasive procedures. These systems are operated by trained surgeons and provide several technical advantages over traditional open and laparoscopic surgery, such as three-dimensional vision, increased dexterity of movement, and decreased fatigue (Duta et …

Robotic surgery, also known as robot-assisted surgery, is a modern surgical technique that involves the use of robotic systems to perform minimally invasive procedures. These systems are operated by trained surgeons and provide several technical advantages over traditional open and laparoscopic surgery, such as three-dimensional vision, increased dexterity of movement, and decreased fatigue (Duta et al., 2023; Chen et al., 2017; George et al., 2018; Lan et al., 2019).

Robotic surgery has seen rapid adoption across various surgical disciplines, including urology, gynecology, and general surgery, and is now a mainstay of minimally invasive surgery in many countries (Rassweiler & Teber, 2016). The Leonardo Da Vinci surgical robot, developed by Intuitive Surgical, IBM, MIT, and Heartport, is one of the most widely used surgical robots and has been applied in general surgery, thoracic surgery, urological surgery, obstetrics, and gynecological surgery (Kim et al., 2020).

While robotic surgery has revolutionized laparoscopy and increased its distribution, it is associated with considerable costs. Additionally, there is ongoing debate regarding the clinical safety and cost-effectiveness of robotic surgery, with limited evidence to support its advantages in certain surgical procedures (Guerra et al., 2016; Jung, 2022). Some studies have failed to demonstrate the superiority of robotic surgery over laparoscopic surgery in terms of oncologic and postoperative outcomes. Furthermore, robotic surgery has been associated with longer operative times compared to conventional laparoscopic approaches (Sawada et al., 2015; Nozawa & Watanabe, 2017).

Despite these challenges, robotic surgery is increasingly regarded as an effective and surgeon-convenient treatment option, particularly in procedures such as rectal surgery, where it has been reported to reduce conversion rates and offer technical advantages for specific surgical tasks (Cheong & Kim, 2017; Jeon et al., 2019). Robotic surgery is also considered more beneficial for less experienced surgeons, as it allows for faster and more accurate training compared to laparoscopic surgery (Lee et al., 2020).

In conclusion, robotic surgery represents a significant advancement in modern surgical techniques, offering technical advantages and potential benefits for both surgeons and patients. However, ongoing research is necessary to further evaluate its clinical safety, cost-effectiveness, and overall efficacy compared to traditional surgical approaches.

References:

Chen, S., Wu, M., Hsu, T., Yen, D., Chang, C., Hsu, W., … & Lee, C. (2017). Comparison of outcome and cost among open, laparoscopic, and robotic surgical treatments for rectal cancer: a propensity score matched analysis of nationwide inpatient sample data. Journal of Surgical Oncology, 117(3), 497-505. https://doi.org/10.1002/jso.24867

Cheong, C. and Kim, N. (2017). Minimally invasive surgery for rectal cancer: current status and future perspectives. Indian Journal of Surgical Oncology, 8(4), 591-599. https://doi.org/10.1007/s13193-017-0624-7

Duta, C., Pantea, S., Brebu, D., Dobrescu, A., Lazăr, C., Botoca, K., … & Lazar, F. (2023). The robotic approach in rectal cancer.. https://doi.org/10.5772/intechopen.100026

George, L., O’Neill, R., & Merchant, A. (2018). Residency training in robotic general surgery: a survey of program directors. Minimally Invasive Surgery, 2018, 1-7. https://doi.org/10.1155/2018/8464298

Guerra, F., Pesi, B., Bonapasta, S., Perna, F., Marino, M., Annecchiarico, M., … & Coratti, A. (2016). Does robotics improve minimally invasive rectal surgery? functional and oncological implications. Journal of Digestive Diseases, 17(2), 88-94. https://doi.org/10.1111/1751-2980.12312

Jeon, Y., Park, E., & Baik, S. (2019). Robotic surgery for rectal cancer and cost-effectiveness. Journal of Minimally Invasive Surgery, 22(4), 139-149. https://doi.org/10.7602/jmis.2019.22.4.139

Jung, W. (2022). Current status of robotic surgery for colorectal cancer: a review. International Journal of Gastrointestinal Intervention, 11(2), 56-60. https://doi.org/10.18528/ijgii220009

Kim, Y., Byun, C., Kim, S., Kang, C., Kim, W., Park, Y., … & Han, S. (2020). A proposal of “clinical privileges on robotic surgery” by the korean association of robotic surgeons (karos). Annals of Robotic Innovative Surgery, 1(1), 2. https://doi.org/10.37007/aris.2020.1.1.2

Lan, H., Zhe, T., Li, K., Gao, J., & Liu, T. (2019). Intramedullary nail fixation assisted by orthopaedic robot navigation for intertrochanteric fractures in elderly patients. Orthopaedic Surgery, 11(2), 255-262. https://doi.org/10.1111/os.12447

Lee, S., Kim, M., Seong, S., Paek, J., Lee, Y., Nam, E., … & Cho, C. (2020). Trends in robotic surgery in korean gynecology. Gynecologic Robotic Surgery, 1(2), 50-56. https://doi.org/10.36637/grs.2020.00059

Nozawa, H. and Watanabe, T. (2017). Robotic surgery for rectal cancer. Asian Journal of Endoscopic Surgery, 10(4), 364-371. https://doi.org/10.1111/ases.12427

Rassweiler, J. and Teber, D. (2016). Advances in laparoscopic surgery in urology. Nature Reviews Urology, 13(7), 387-399. https://doi.org/10.1038/nrurol.2016.70

Sawada, H., Egi, H., Hattori, M., Suzuki, T., Shimomura, M., Tanabe, K., … & Ohdan, H. (2015). Initial experiences of robotic versus conventional laparoscopic surgery for colorectal cancer, focusing on short-term outcomes: a matched case-control study. World Journal of Surgical Oncology, 13(1). https://doi.org/10.1186/s12957-015-0517-6

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