What is Robotic Surgery ?

Da Vinci Xi Surgical robot is the most advanced platform in the world to perform minimally invasive surgery.

A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks.

Welcomed our second Da Vinci Xi Robotic System within 6 months of joining. Inaugurated the Robotic system today at Max Patparganj with a Robotic Bariatric Surgery. Invoking almighty to bless us and our patients

  • The surgeon’s master console is the robot’s user interface that provides the master surgeon with the following functions:

    • A 3-dimensional view of the surgical field relayed from an endoscopic camera inside the patient’s body in control of the robot that creates a sense of being “immersed” into the surgical field.
    • Master manipulators, which are handles or joysticks that the surgeon uses to make surgical movements that are then translated into real-time movements of the slave manipulators docked on the patient. Motion scaling (conversion of large natural movements to ultraprecise micromovements) and tremor filtering increase accuracy and precision of the surgeon’s movements.
    • A control panel to adjust other functions, such as focusing of the camera, motion scaling, and accessory units.
  • Patient-side slave robotic manipulators are robotic arms that manipulate the surgical instruments and the camera through laparoscopic ports connected to the patient’s body. The da Vinci system handles surgical instruments with microarticulations near the tip (EndoWrist) that can duplicate motions of the human wrist, including rotation (7 degrees of freedom, ie, the greatest possible motion around a joint).

Advantages of robotic surgery ?

  1. Shorter stays in the hospital

Because robotic surgery is minimally invasive, there is usually less of a need to keep people in the hospital for very long. Shorter hospital stays also translate to faster recovery times, which means you can get back on your feet and return to work and your routine sooner. Spending fewer days in the hospital also leads to cost savings, which is always a good thing in an already costly health system.

  1. Reduced pain and discomfort

For many patients, recovering from surgery is tougher than undergoing the surgery itself. The smaller incisions needed by robotic surgery generally means patients feel less pain and discomfort following their procedure.

3 . Reduced chances of infection

One of the most dire complications associated with traditional surgery is the risk for infection, and smaller incisions usually means the likelihood for infection is less. Instead of having the entire abdominal cavity opened for a procedure, the wound size associated with the robotic surgery is much smaller and easier to monitor and control.

  1. Lower levels of blood loss and transfusions

Maintaining normal blood levels during a surgical procedure is a top concern. Robotic surgery involves less blood loss because the three-dimensional view allows the surgeon to see blood vessels more easily than they can during traditional open surgery. This enhanced view, combined with the precise movements of the robotic instruments, means surgeons can better avoid blood vessels adjacent to the surgical field.

  1. Minimal scarring

The potential for scarring is less due to the smaller size of the incisions. The incisions are referred to as “keyhole” incisions because they are generally small enough for the camera and robotic arms to be guided through. Procedures like appendix or gallbladder removal, which may have once required the surgeon to open the entire abdominal cavity, only need a few small incisions when robotic surgery is employed. Minimal scarring is definitely a reasonable cosmetic consideration for many people

Clinical Applications of Robotic Surgery

Bariatric Surgery : Robotic sleeve gastrectomy , Roux en y Gastric Bypass

Hernia Surgery : Abdominal wall reconstructions , Ventral and incisional Hernia Repair , inguinal hernia Repair

Robotic gastrointestinal surgery :  Robotic cholecystectomy, Antireflux operations, Heller’s myotomy, gastric bypass, gastrojejunostomy, esophojectomy, gastric banding colectomy, splenectomy, adrenalectomy, and pancreatic resection reported to date

Robotic urologic surgery : Robotic Radical prostatectomy, Robotic Kidney surgery, Robotic Renal transplant, Robotic pyeloplasty

Robotic gynecologic surgery : Robotic hysterectomy, salpingo-oophorectomy, and microsurgical fallopian tube reanastomosis

Robotic thoracic surgery

Robotic oncologic surgery : Esophageal tumors, gastric cancer, colon cancer, thymoma, and retromediastinal tumors

Advantage of robotic surgery over laparoscopic surgery

Laparoscopic Limitations/Robotic Solutions

Laparoscopic Problems/Limitations

Robotic Surgery Solutions/Potential

Two-dimensional vision of surgical field displayed on the monitor impairs depth perception

Binocular systems and polarizing filters create 3-dimensional view of the field

Movements are counterintuitive (ie, moving the instrument to the right appears to the left on the screen due to mirror-image effect)

Movements are intuitive (ie, moving the control to the right produces a movement to the right on the viewer)

Unstable camera held by an assistant

Surgeon controls camera held in position by robotic arm, allowing solo surgery

Diminished degrees of freedom of straight laparoscopic instruments

Microwrists near the tip that mimic the motion of the human wrist

Surgeon forced to adopt uncomfortable postures during operation

Superior operative ergonomics: surgeon comfortably seated on the control console

Steep learning curve

Shorter learning curve

Amplification of tremor of hand of surgeon                                                                Removes tremor and makes the tip of instrument stable