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A robot can be defined as a computerized system which has a motorized construction capable of interacting with the environment. Robotic surgery is the use of robot to assist in the surgery process instead of a human-being or in a human-like way.

Introduction & Definitions to Da Vinci Robotic Surgery

With the advent of science and technology, the field of robotic surgery is fast growing. Some of the major advances that have taken place in the surgical area include the options such as remote surgery, minimally invasive surgery, and unmanned surgery. The robot-assisted surgery offers the advantages of precision, smaller incisions, reduced blood loss, decreased pain, and faster healing time. The introduction of robots has revolutionized the medical and surgical fields wherein the doctors have the advantage of treating a higher number of patients while the patients have the benefits of minimal time spent in the hospital. All in all, it results in faster treatment and better recovery rate.

Da Vinci Robotic Surgery

The da Vinci robotic surgery is carried out with the help of the da Vinci Surgical System. This surgical system is comprised of three major components [1]: 

  • the console (through which the surgeon performs the operation), 
  • side robotic cart (placed by the side of the patient) that has 4 robotic arms that can be manipulated by the surgeon from the console, 
  • and a high-definition 3D vision system which can magnify the image up to 10 times

Three of the robotic arms are mounted with the surgical instruments which are controlled by the operating doctor through the console. The fourth robotic arm is used to control the camera. While the robotic arms move according to the movements of the surgeon’s hands, the camera provides a high definition video of the procedure being carried out. 

The operating surgeon has the benefit of viewing a three-dimensional, magnified, video image and can rotate his hands more freely than with the conventional technique. Different kinds of instruments can be attached to the robotic arms according to the procedure to be performed. Additionally, the robotic arms are capable of performing a full circular movement which is not possible by non-robotic arms.[1]

Uses

The FDA has cleared the da Vinci Surgical System for performing a variety of surgical procedures. Da Vinci robotic surgery is used to perform different methods such as surgery for prostate cancer, hysterectomy, and mitral valve repair. It is currently being used in more than 800 hospitals across America and Europe. Approximately 80,000 out of 230,000 new cases of prostate cancer undergo surgery because of the high-risk invasive surgery carries, which implies the number of new cases could be higher in the future.[1]

Pros and cons of da Vinci robotic surgery

The use of robots for surgical procedures offers several benefits. Nevertheless, they are not 100% efficient. There are certain limitations to the use of robots. Some of these include : 

  • inability to make judgments independently, 
  • limited dexterity, 
  • not suitable for complex procedures, 
  • expensive and difficult to produce.

The da Vinci robotic surgery is not devoid of these limitations. However, it offers several benefits that overcome its limitations. We shall discuss some of the advantages and disadvantages of the da Vinci robotic surgery below.

Pros of da Vinci robotic surgery

The da Vinci Surgical System has several advantages. Owing to the minimal amount of incisions required to aid the movements of the robotic arms, it ensures faster healing. Thereby it reduces hospital stays by about half of that needed for conventional procedures, which, in turn, reduces the hospital cost by about 33%.

Additionally, the procedure is less painful and is associated with a quicker recovery. Since the incisions required are small, it does not leave a large surgical scar when the wound heals. Therefore it has been proposed to be useful in children also (being used in limited cases). In addition, The da Vinci surgical system reduced the average 2-3% wound infection to nearly zero.

A robotic arm controls the endoscopic instruments instead of direct manipulation by the surgeon’s hands — these arms remain steady at all times and electronically dampen the “shake” of the human hand.

In most of the surgical cases, patients are worried about the invasiveness of the surgery and the risks involved with it, which leads to avoiding of surgical procedures which often leads to several complications. However, with the introduction of robotic surgery more patients are opting for the surgical treatments owing to the minimal invasiveness of these procedures.

To sum up, the advantages of the da Vinci robotic surgery include the following:

  • Simpler procedure
  • Minimally invasive
  • Better technique
  • Reduced bleeding
  • Less painful
  • Smaller scar
  • Faster healing
  • Decreased hospital stay

Cons of da Vinci robotic surgery

While the da Vinci robotic surgery offers several advantages in comparison to the traditional surgical techniques, few disadvantages limit its widespread use.[2]

One of the main drawbacks of this technology is the amount of time required for a surgeon to master its use. It takes some time before a surgeon can perform surgeries confidently with the use of this technology. On average, surgeons operated on about 12-18 patients before they felt comfortable performing the procedure.[1]

Next constraining factor is the cost of the device. Almost costing up to $1 million the invention is not affordable to many of the smaller hospitals.

Some of the other drawbacks are related to its use. The surgeons lack the tactile or haptic sensation (in simple terms, the ability to “feel” the tissues the surgeon operates on) while using this device, which has been considered by a few surgeons as a hindering factor as the natural feeling of operating on a patient is lost. 

Additionally, a large space occupied by the side-cart reduces the access for the health professionals assisting the surgeon in the surgery.

Thereby the disadvantages of the da Vinci robotic surgery include:

  • Longer learning period
  • High cost of the equipment and thus the procedure
  • Reduction in space for assistants
  • Lack of tactile sensation for the surgeon

Future

The da Vinci robotic surgery is preferred for the advantages associated with it. While the drawbacks may limit its widespread use, further innovations in the technology can help overcome these disadvantages. Better care, minimal pain, and faster recovery are some of the positive features of the da Vinci robotic surgery which is increasing its popularity both among surgeons and patients.