What is robotic surgery?

Robotic surgery is laparoscopic surgery that utilizes the da Vinci robot system to assist in performing technically challenging procedures. The doctor sits at a "console" and controls the robotic arms that are attached to the laparoscopic instruments. This allows the surgeon to perform more intricate dissection, and delicate suturing safely. I use the da Vinci robot for difficult hysterectomies, endometriosis, and some surgeries to help with severe pelvic organ prolapse. I do not believe robotic surgery is necessary for all types of gynecologic surgery and most gynecologists should be capable to perform many surgeries laparoscopically without the assist of a robot. In my opinion, the robot does help with very technically challenging surgeries and I believe robotic surgery is useful in giving patients an option to have safe minimally invasive surgery rather than a large incision and long recovery.

While robotic surgery is not appropriate for every procedure, it is particularly helpful for operating on parts of the body that are difficult to access without making a large incision. During robotic surgery, the surgeon uses the assistance of a robot to operate on the patient through tiny holes (or ports) in the body instead of a large open incision. Robotic technology consists of a surgeon's console that controls a tower with four working arms. One arm controls the three-dimensional camera's movements inside the body, while the remaining three arms hold specialized laparoscopic instruments. The robotic arms precisely replicate the surgeon's hand and finger movements from the console.

At the start of the robotic surgery, miniature instruments are introduced into the body by the surgeon via small tubes, eliminating the need for larger incisions. During robotic surgery, the surgeon sits at a console where he can manipulate the miniature instruments. The end of the instrument has three different hinges that allow the surgeon to rotate, spin, and move the instrument in any direction. The surgeon is able to control the instruments as nimbly as he or she would with their own fingers and wrists and in an intuitive fashion. The robot can only respond to the surgeon's movements and motions, and it is incapable of moving on its own, thereby ensuring safe outcomes.

Robotic surgery is a minimally invasive technique (i.e. uses tiny incisions) that was originally developed as a way to operate on wounded soldiers who couldn't get to an expert surgeon. With robotics, the surgeon can operate remotely, sitting at a console miles away and moving levers to control the robots "arms" and maneuver instruments, which are placed into the patient by an on-site surgeon.

While robotic surgery was originally designed to be performed from a distance, most robotic surgery is currently performed with the primary surgeon sitting at a console in the same room as the patient, and a second surgeon standing in the traditional spot next to the patient. Robotic instruments can do things traditional laparoscopic instruments cannot, like twist, turn and maneuver around corners. In addition, the technology allows the surgeon to have a magnified 3-D perspective, almost like standing inside the body while operating. The result is the ability to see and do things that can’t be done otherwise. In the event that a procedure can’t be completed robotically and an incision needs to be made, both surgeons are in the room and can proceed.