Robotic surgery is a safe and effective minimally invasive surgical technique for certain urological procedures. However, it entails a sizeable investment in equipment and specific training for surgeons.
This makes it important that you understand how robotic surgery works and your urologist’s role in the process. Read on to find out more.
What to Expect
The robotic system translates the surgeon’s hand movements into real time, which allows for more precision inside the body. The surgeon is in control of the robot at all times, making sure it responds to what they are doing inside your body.
During the procedure, your doctor makes one or more small keyhole incisions in your abdomen, allowing them to see internal structures on a video monitor. Carbon dioxide gas is pumped into the abdomen, which makes it easier to view the structures. One of the incisions accommodates a flexible camera called an endoscope that lights and magnifies the structures, and the other incisions house surgical instruments.
A Robotic surgery offers advanced solutions for treating several urological conditions, including prostate cancer, bladder cancer, kidney stones, and enlarged prostate (BPH). If your doctor recommends robotic surgery for you, please inquire about their expertise with this cutting-edge technique and the outcomes observed in patients who have undergone robotic surgery
As with all surgical procedures, robotic surgery is not without its risks. Patients who undergo robotic surgery should be careful to take it easy for the first few weeks after treatment, and avoid putting any strain on their incision site. They should also attend all follow-up appointments with their urologist and call the office right away if they have any new or worsening symptoms.
Preparation
Robotic surgery requires a sizeable investment in specialised equipment and surgeon training. Therefore, it is not available at all medical centres. Robotic urological surgical treatments include radical prostatectomy (removal of the prostate gland), partial nephrectomy (removing part of a kidney) and cystectomy (removal of the bladder).
After anesthetizing you, the uro surgeon makes one or more tiny incisions in your abdomen. These openings allow the insertion of ports (thin tubes). Through these, a long thin camera provides high-definition images in 3D, and instruments that are controlled by the robotic system are inserted. The surgeon sits at a console a few feet away and controls the robotic arms while an assistant remains next to you to shift the instruments when needed.
While the robot’s movements are precisely replicated inside your body, the surgeon must still be in control of the procedure and must make decisions during the operation, which cannot always be done using a computer. It is important that you have a urologist like Dr. Marlon Perera who performs robotic surgeries regularly and has a good understanding of the benefits and limitations of this technology
Your urologist, will discuss all your treatment options with you and help you determine if robotic surgery is right for you. If it is not, your doctor will suggest alternative surgical approaches or medical treatments to address your condition.
Procedure
During robotic surgery, your surgeon makes several small incisions through which a thin tube-like device is inserted. It houses a lighted, magnified 3D camera and surgical instruments. Your surgeon uses master controls at a console a few feet away to guide the robot’s arms. They mimic the movements of your surgeon’s hands and wrists — but at a much smaller scale allowing greater precision.
As a result, your doctor is able to perform more complex procedures that aren’t possible with laparoscopy alone. This includes removing hard-to-reach tumors and performing complicated operations on the pelvic area like pyeloplasty or ureteropelvic junction obstruction.
Robotic surgery is less invasive than traditional open or laparoscopic surgeries, which means less blood loss, lower risk of infection and shorter hospital stays. Many patients experience less pain during recovery and don’t need opioids afterward.
Your urologist can help determine if you’re a good candidate for robotic surgery. They can explain your procedure’s risks and benefits to help you make an informed decision. You should also consider whether you have conditions or comorbidities (having more than one medical condition) that might limit your ability to safely undergo surgery. Not all doctors offer this type of surgery, so you’ll want to find an experienced provider. Ask how many robot-assisted procedures they’ve performed. You should also learn about your surgeon’s education and training.
Recovery
If you decide to undergo robotic surgery, your doctor will make an incision in the abdomen and then insert a camera and surgical instruments through temporary ports. The robot translates your surgeon’s hand, wrist and finger movements into precise, computerized actions in real-time inside the body. This technology allows urologists to remove prostate tissue with great precision, while preserving nerves that control bladder function.
When the procedure is over, the doctor removes the ports. Most patients experience minimal pain after a robotic prostatectomy and are discharged one day after surgery, though certain conditions may require a longer hospital stay. Some patients are able to stop using narcotics after two days, after which Extra Strength Tylenol can help with pain control.
During the procedure, you will be under general anesthesia. When you wake up, you’ll be in a recovery room with nurses nearby to help. You’ll be encouraged to get up and walk around as soon as possible after the procedure to prevent blood clots and speed healing.
CU Department of Surgery faculty member Robert Meguid and surgery resident Adam Dyas found that many surgeons give patients false guidance about recovery after robotic lung dissections. They decided to gather data and study it. They discovered that the advice that most surgeons provide might be based on anecdotes and outdated information, which can lead to unrealistic expectations for patients about how long it will take them to recover.
