Robotic Surgery
Robotic surgery can be seen as an evolution of laparoscopic surgery, representing a further technological improvement in minimally invasive surgery. It employs the same approach to accessing the abdominal cavity, using a closed abdomen with small openings for camera access and 3 or 4 additional openings for instruments.
The robotic platform (currently, the most widely used worldwide is the Da Vinci system by Intuitive) consists of:
- A patient cart with four mechanical arms to support the camera and instruments
- A surgical console from which the surgeon maneuvers the instruments and video endoscope using two joysticks, looking through a visor and using specific pedals to control energy modalities for coagulation, magnify the field of vision, and view instrumental images (intraoperative ultrasound)
- A vision tower that includes image processing systems and a touchscreen monitor for the surgical team.
This highly technological system is periodically updated and improved, allowing the surgeon to perform the procedure remotely (within a few meters of the operating bed where the patient lies) with undeniable advantages, including:
- Magnified and three-dimensional vision
- Instrument rotation capabilities of up to 360 degrees, allowing for particularly delicate and precise movements
- Stability of the surgical field, which is unaffected by involuntary movements of the surgeon and assistants, allowing for safer performance of certain surgical tasks that require precision
One or more assistants are present at the operating bed to change instruments and assist the lead surgeon during the procedure.
Since its introduction in the market and operating rooms, its popularity has grown, particularly for results in urology, but it has progressively been used in general surgery with excellent outcomes in gastrointestinal and biliopancreatic tumor surgery. In small fields, such as the pelvis, it allows for accurate recognition of vascular and nerve structures (to be cut or preserved), enabling precise surgeries even in oncological contexts, achieving similar oncological radicality as open surgery with the maximum benefits of minimally invasive techniques.
Many procedures are now standardized and routinely performed in hospitals and private facilities that have the technology available.
