The evolution of minimally invasive surgery in the last decade has changed the basis of modern surgery. For many years, laparoscopy has been considered the paradigm of this new form of surgery. However, it is commonly accepted that, in spite of being a revolutionary surgical progress, limitations and difficulties when performing certain abdominal procedures are encountered when using laparoscopic methods.
The incorporation of computer-assisted surgery and its gradual development has increased the technical options for patients with digestive pathologies who require a surgical procedure that ensures safety, effectiveness, minimal invasion and aggressiveness. When robotic surgery is used in adequate contexts, it reduces the risks of open surgery and overcomes the advantages of laparoscopic surgery.
Highly qualified hospitals throughout the world have gradually incorporated this technique to their technological resources, and therefore they can offer wider therapeutic options for their patients.
The surgeon has no direct contact with the patient when using robotic surgery. They use a console located in the same operation room or even in another location or country. The device is equipped with a 3D vision system and ergonomic controls that feature the same skills as the human hand. Using these controls, the surgeon sends the commands to the robot located next to the operating table, and this robot reproduces with great precision the surgeon's commands thanks to its three arms. A fourth arm controls the 3D endoscopic camera.
ADVANTAGES OF ROBOTIC SURGERY
TECHNICAL ADVANTAGES OVER LAPAROSCOPIC SURGERY
- The 3D image improves the perception of the depth of the surgical field.
- The manual movements performed by the surgeon are natural, instead of the less intuitive and uncomfortable positions that traditional laparoscopic surgery requires. The console features offer a remarkable comfort to the surgeon and reduce fatigue during the procedure.
- The robotic system digitalizes the movements of the surgeon and therefore eliminates any hand tremor. A wide movement in the console is translated as a small and precise one in the surgical field.
- The translation of the movement from the console to the instruments improves the hand-eye coordination.
- The robotic arms provide additional degrees of freedom inside the patient increasingagility and precision. Compared to the rigid and fixed laparoscopic instruments, these robotic arms include additional joints that reproduce the human wrist movements with greater accuracy.
ADVANTAGES FOR THE PATIENT
- Reduction of pain
- Reduction of blood loss during the surgical procedure
- Reduction of postoperative complications, included infectious ones
- Shorter hospital stays
- Shorter postoperative recovery
- Better plastic results and less scarring
- Hiatus hernia
- Benign or malignant liver tumors
- Benign or malignant liver pancreatic tumors
- Benign or malignant gastric tumors
- Benign or malignant esophageal tumors
- Benign or malignant small bowel tumors
- Benign or malignant colorectal tumors
- Small bowel or colon inflammatory disease
- Benign or malignant adrenal gland tumors
- Benign or malignant retroperitoneal tumors
- Obesity surgery
- Gastric bypass
Robotic surgical technique
- Gastroesophageal reflux Anti-reflux
- Liver resection
- Pancreatic resection
- Gastric resection
- Transhitatal or transthoracic esophageal resection
- Small bowel resection
- Colorectal resection
- Small bowel or color resection
- Adrenal glands resection
- Tumor resection
- Adjustable gastric banding
- Sleeve gastrectomy