Robotic surgery

Technique in which a surgeon performs surgery using a computer that remotely controls very small instruments attached to a robot.

Refers to computer-assisted surgery, and robotically-assisted surgery that use robotic systems to aid in surgical procedures.

Tends to be slightly more expensive then open or laparoscopic surgery.

Robotic surgery is easier to learn than the other 2 types of surgeries.

The robotic platform make surgery easier for the surgeon, makes the surgery highly precise and more doable in certain clinical situations adding value to the procedure.

The surgeon uses one of two methods to control the instruments ; either a direct telemanipulator or by computer control.

A telemanipulator is a remote manipulator that allows the surgeon to perform the normal movements associated with the surgery as the robotic arms carry out those movements using end-effectors and manipulators.

In computer-controlled systems the surgeon uses a computer to control the robotic arms and its end-effectors.

With the computerized method the surgeon could be anywhere in the world, leading to the possibility for remote surgery.

Procedure is done under general anesthesia.

Instruments are inserted through small surgical incisions.

Robot movements match physicians hand movements to perform the procedure using the inserted instruments.

A camera introduced intraabdominally allows magnified three-dimensional images presented on a monitor in real time.

The procedure is similar to laparoscopic surgery.

Robotic arm is easier to use than the instruments in endoscopic surgery.

The robot reduces the surgeon’s movements, and reduces hand tremors and movements that might otherwise make the surgery less precise.

Robotic surgery increases range of motion with instrumentation, provides three-dimensional stereoscopic visualization, and improved ergonomics for the surgeon.

Has an absence of a fulcrum affect, has 7 versus 4 degrees of freedom of movement compared to usual laparoscopy,

Robotic instruments can access hard-to-reach areas of the body.

Robotic surgery can take longer to perform than open surgery.

Disadvantages include the absence of tactile feedback and instrument collisions when crossing wide surgical fields.

Robotic surgery may be used for a number of different procedures, including: coronary artery bypass, cholecystectomy, hip replacement, nephrectomy, renal transplant, heart valve repair, pyloroplasty, prostatectomy, tubal ligation, and hysterectomy, colon and rectal cancer surgery, adrenalectomy, pancreatic tommy, gastrectomy, hepatectomy, lung lobectomy, and esophagectomy.,

Associated with fewer risks than open and laparoscopic surgery.

Benefits compared with open surgery include:smaller openings, faster recovery time, less pain, less bleeding, lowered infection risks, shorter hospital stays.

In gynecological cancers robotic surgery achieves a high yield of lymph nodes for full dissection and brings a high level of precision to Sentinel node dissection, increasing chances of a better result.

A randomized trial found patients who went laparoscopic or robotically assisted radical hysterectomy for early-stage cervical cancer had lower rates of disease free and overall survival than those treated with open abdominal hysterectomy.

In general, open surgery versus robotic surgery for radical cystectomy are comparable: robotic procedures have longer operative times, decreased blood loss, and only modest reductions in length of stay.

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