Laparoscopic Versus Robotic Surgery
Rather than using a large incision, laparoscopy involves using several small incisions to perform a surgical procedure. Robotic surgery is a laparoscopic procedure, only with an added layer of technology. As with other laparoscopic procedures, the surgeon makes a button-size incision in the abdominal cavity for the insertion of a telescope. After expanding the abdominal cavity with carbon dioxide gas, three additional small incisions are made to place narrow tubes used for interchangeable instruments. Instead of the surgeon’s hands directly moving the instruments, the robotic device is wheeled up to the patient and the robotic arms are attached to the telescope and the instruments. The surgeon then sits at the control console a few feet from the patient, leaving the surgical assistant and scrub nurse at the patient’s side. One or two additional small tubes are often placed for the surgical assistant to use.
The surgeon then views a highly magnified, three-dimensional image of the patient’s interior structures. All movements of the camera and robotic instruments are precisely performed in real-time by the surgeon using ergonomic finger controls. The tips of these instruments can make any wrist-like turn that the surgeon so desires. The procedure is performed using instruments such as miniature tweezers and scissors the size of a fingernail (although these scissors appear to be the size of hedge clippers to the surgeon observing them via video).
Benefits of robotic surgery:
- Short recovery– As with any laparoscopic procedure, robotic surgery usually leads to a quicker recovery and less post-operative pain compared to open-incision surgery.
- True 3D view– The thin telescope inserted into the patient’s body actually contains two lenses, each served by a separate camera. At the control console, Scott D. Miller, MD views a slightly different image with each eye, giving him a true 3D image. This ability allows smoother instrument movements and better appreciation of subtle tissue characteristics.
- Increased surgeon control– With laparoscopic surgery, each hand controls one instrument or the camera (a total of two items). With robotic surgery, Dr. Scott Miller controls all camera movements and three instruments (four items).
- “Scaling” of movement – The robotic instruments move proportionately smaller distances in the body than the hand controls move at the surgeon’s control console. This added precision is particularly useful with the system’s magnified view.