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Robotic surgery or robot-assisted surgery is an innovative method, associated with non-invasive or minimally invasive surgeries such as laparoscopy. A surgical robot is a device controlled by a computer which has been programmed to help the placement and usage of surgical instruments. The most widely used robotic surgical procedure involves mechanical and camera arms, containing surgical instruments controlled by the surgeon from a computer. The surgery is being increasingly accepted since it allows better clarity, high-definition vision of the surgical site and also allows conducting complex procedures with enhanced precision, flexibility and control.

Most often this type of surgery is associated with non-invasive or minimally invasive procedures. However, in some cases, it is also used to perform traditional open surgical procedures. One of the most common types of robotic surgery is a robotic laparoscopic procedure. Robotic laparoscopic surgery has been conducted since the 1980s to overcome the limitations of a general laparoscopy such as two-dimensional view, partial articulation of surgical instruments, and lack of efficiency. Robotic laparoscopic surgery helps to overcome these limitations and convert invasive surgeries such as laparotomy into minimally-invasive methods. 

Advantages of Robotic Surgery

Several advantages of robotic surgery include:

  • Improved precision, flexibility and control
  • A better view of the problem area
  • Promotes complex surgical methods
  • Fewer complications
  • No infections
  • Minimum and bearable pain
  • Lesser trauma
  • Less blood loss
  • Less scarring – which can be cosmetically treated
  • Easy and fast recovery
  • Faster resuming of normal activities

Different Types of Robotic Surgeries

Some procedures that have been successfully done by through the robotic-technique are:

  • Repairing of hernia
  • Pyloroplasty – Widen the opening of the lower stomach
  • Removing of the adrenal gland
  • Appendix removal
  • Gallbladder removal
  • Removal of colon
  • Kidney removal
  • Reinforcing the valve between esophagus and stomach
  • Prostate removal
  • Uterus removal
  • Treating fibroids

Complications of Robotic Surgery

Robotic surgery has rare complications, though some general problems that may arise during or post the surgery include:

  • Possible damage to surrounding organs and tissues
  • Infection
  • Bleeding
  • Reactions or allergies to anaesthesia
  • Failure of surgery and need for an invasive traditional method

Risk Factors of Robotic Surgery

A few factors increase the likelihood of complications in robotic laparoscopic surgery. These factors include:

  • Smoking
  • Chronic heart problems
  • Existing lung issues
  • Obesity
  • Diabetes
  • Excessive alcohol
  • Drug and substance abuse
  • History of abdominal or pelvic operation
  • Certain medications

All factors must be discussed with the doctor before the surgery to avoid serious problems.

The procedure of Robotic Surgery

The actual procedure of robotic surgery depends on the type of surgery being performed. However, generally, since the technique is more used in performing non-invasive or minimally invasive surgeries, a typical procedure will be similar to the below:

Like a normal surgery, even in a robotic technique, the doctor will conduct physical exams and several other tests such as blood tests, urine tests, ECG, X-ray, ultrasound or a CT scan to assess the condition of the organ. 

All current medications, health problems, allergies must be discussed with the doctor beforehand and medications, diet, etc. as suggested by the doctor must be taken as advised. Moreover, a family or friend in assistance must be called for. 

Before beginning the procedure, the doctor will place the patient under anaesthesia – general or local – depending on the intensity of the procedure. Post this, the doctor makes small incisions, also called keyhole incisions to allow carbon dioxide to enter the abdomen for it to expand, making it easier to visualize the area.

Post this, an endoscope is inserted into the area through one of the incisions, which provides clear, magnifying images of the organ on a monitor. This endoscope is attached to a robotic arm, while the other robotic arm holds forceps, scissors, dissectors and scalpels – needed to hold, cut, dissect and close the surgery. All this while, the doctor monitors the screen images and then guides the robotic arms to perform the surgery. The surgery is about 1-2 hour long and does not cause pain because of the influence of anaesthesia. However, even post-operative pain is very less and can easily be managed with some medications. That said, gas problems might occur for a few days post the surgery but will eventually smoothen. A person recovers easily within 3-5 days and can resume normal, routine activities post complete recovery unless there are any complications. 

Post the procedure, the doctor will also advise on the steps to be followed to enhance recovery and ensure no complications. You may be advised to:

  • Clean the incisions with soft soap and water
  • Avoid rigorous activities 
  • Take one day at a time; do not rush the recovery process
  • Undertake physical therapy, if required

It is also important to understand the alarming symptoms that must be noted if they appear to post robotic surgery. Some of the symptoms that would need you to call the doctor are:

  • Infection 
  • Fever and chills
  • Excessive bleeding
  • Uncontrollable pain
  • Discharge, redness, swelling at the incision site
  • Bloody stool
  • Nausea and vomiting
  • Bowel problems
  • Loss of consciousness
  • Extreme headache
  • Extreme vaginal bleeding or discharge
  • Breathlessness
  • Chest pain
  • Swelling and pain in the abdomen 
  • Inability to eat or drink
  • Digestive problems
  • Swollen legs and feet

Overall, the benefits of a robotic surgery outweigh the few, rare complications and risks. However, each case needs to be evaluated individually; hence, advice from a doctor should be taken before deciding on the procedure.

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