Robotic Surgery

In spite of its futuristic name, robotic surgery is not performed by some version of R2D2, the robot in Star Wars. Rather, robotic surgery uses computerized robotic systems to assist in surgical procedures.

The ability to use robotic-assisted surgery started with endoscopic surgery. (Read about "Endoscopy") Endoscopic surgery uses small incisions and devices on the end of tubes, along with a camera to perform the surgery. Conventional endoscopic surgery still requires that a surgeon manipulate those tools directly. Robotic surgery takes the next step, which is to attach those tools to robotic arms, assisted by computer technology.

With robotic surgical systems, also called computer-assisted surgery, surgeons don't move the actual surgical instruments directly with their hands. For example, in some robotic procedures, surgeons sit at a console several feet from the operating table and use joysticks similar to those used in video games. They perform surgical tasks by guiding the movement of the robotic arms in a process known as telemanipulation. The da Vinci Robotic Surgery System was the first robotic system approved by the Food and Drug Administration (FDA) for assisting surgery in this way. In other robotic procedures, the robotic arms are manipulated by the surgeons more directly.

Robots have superhuman capabilities that make surgery easier. For instance, they don't tire. Robotic arms don't have a tremor, so they can remain steady at all times and robotic wrists make it easier for surgeons to manipulate tissue and work from all kinds of angles. FDA, which must approve all such devices, says robotic surgical machines have a number of other advantages.

Robotic surgical systems can also improve depth perception, giving surgeons three-dimensional vision, compared with the two-dimensional vision they would normally get with normal endoscopic procedures. And the surgical field can be magnified so that millimeter-sized veins appear as big as pencils.

Compared with the long instruments used in endoscopy, robotic surgical systems use smaller instruments that provide increased range of motion. This can be very helpful when operating on children.

Robotics also offers motion scaling, which means that a surgeon's gross hand movements can be reduced to fine movements, allowing for accuracy in tight spaces. For example, with motion scaling, one inch of movement by the surgeon results in a quarter-inch movement by the robotic surgical instruments.

There are also advantages for the patient. FDA says that robotic surgery can mean less time in the hospital along with other positives such as:

• less pain and scarring
• less risk of infection
• less blood loss and fewer transfusions
• faster recovery
• quicker return to normal activities

FDA say there may be times when the surgeon will begin a surgical procedure with the robot and then for one reason or another have to abandon it and do the surgery using traditional methods.

Types of surgery

Originally, robots were used for surgery to remove gallbladders. (Read about "Gallstones") Many surgeries to treat other conditions have been added to the list since then. According to FDA, some of them include:

• removal of the prostate (Read about "The Prostate")
• heart bypass surgery (Read about "Coronary Bypass Surgery")
• mitral valve repair (Read about "The Heart & Its Valves")
• hysterectomy (Read about "Hysterectomy")
• atrial septal defect repair (Read about "Congenital Heart Defects")
• gastric bypass surgery (Read about "Bariatric Surgery")
• gastroesophageal reflux disease (Read about "Gastroesophageal Reflux Disease")
• uterine fibroid removal (Read about "Uterine Fibroids")
• uterine and vaginal vault prolapse
• removal of the thymus gland (Read about "Endocrine System")
• orthopedic procedures such as hip replacement or partial knee replacement (Read about "Joint Replacement" "The Hip" "The Knee")

Some other conditions that can potentially be treated via robotic surgery are cervical cancer, endometriosis, certain menstrual disorders, spinal problems, kidney cancer and some conditions of the ovaries, including ovarian cancer. (Read about "Cervical Cancer" "Endometriosis" "Menstrual Disorders" "The Spine" "Kidney Cancer" "The Ovaries")

Not everyone is a candidate for robotic surgery. You should discuss all options with your physician.