Question

Please describe the difference between regular laparoscopic surgery and the Davinic robot?

List pros and cons.

Minimum of 100 words.

Answer 1

Laparoscopic Surgery
In a traditional open surgery approach, your surgeon uses a large incision to perform the surgery. In laparoscopic surgery, your surgeon makes several small incisions into which he or she inserts small surgical tools and a camera. The camera allows your surgeon to see inside your body to perform the surgery.

All minimally invasive surgery techniques have similar benefits, such as less blood loss, reduced pain, smaller scars, shorter stay in the hospital and faster recovery times. However, there are some limitations to laparoscopic surgery such as 2D images and tools that offer a limited range of motion, which can make it difficult for your surgeon to work in small spaces.

Davinic Robot Surgery
Robotic surgery is similar to laparoscopic surgery in the respect that they both use small incisions, a camera and surgical instruments. However, instead of holding and manipulating the surgical instruments his or herself, during robotic surgery, Surgeon will sit at a computer console and use controls to manipulate the robot. The console provides your surgeon with high-definition, magnified 3D images, which allow for increased accuracy and vision inside your body. Compared to traditional surgery, robotic surgery provides your surgeon with a greater range of motion and precision, which may lead to less bleeding and post-operative pain
Laparoscopic surgery, also referred to as 'minimally invasive surgery' or simply 'keyhole surgery', describes a method of performing operations within the body without needing to make a large incision in the skin to access the internal organs.

A laparoscope is a long flexible tube equipped with a miniature video camera and light on the end that, along with a range of miniaturised surgical instruments, can be inserted into the abdominal cavity through a very small incision or set of incisions which are only 1 or 2cm in length.

Typically, a small amount of gas (normally CO2) is introduced into the abdominal cavity at the same time so that the surgeon is able to clearly see the organs.

Laparoscopic techniques were in use to operate on animals in the early 1900s, with the first laparoscopic procedure on a human conducted in 1910. Laparascopic techniques for a range of different types of surgery became commonplace from the 1990s.

Today most operations to repair herniae are conducted using laparoscopic surgery. The main reasons for this are:

Shorter recovery times (patients are able to return to normal activites around a week earlier).
Normally no need for a hospital stay after the procedure.
Much smaller scars than in open surgery (1-2cm incisions as opposed to 4-5cm incisions).
Generally, less pain after the procedure.
However, the laparoscopic approach does have some potential risk factors as compared to conventional open surgery. These relate to two factors in particular - firstly that the surgeon is using instruments operating at a distance and is not using his or her hands directly so is not able to 'feel' (or 'palpate') body tissue, and secondly that visualisation is via a video camera, which does not give the same depth of vision as direct eyesight. Surgeons who perform laparoscopic surgery routinely have undergone specialist training to take account of these difference so in the right hands the risk of inadvertent injury should be no greater.

The choice of laparoscopic or conventional surgery is often dictated by the type of hernia as well as size and location of the hernia. In general terms, unless there are other factors, the following types of surgery are employed:

Femoral hernia – open.
Inguinal hernia – laparascopic or open.
Parastomal hernia – laparoscopic.
Umbilical herniae – open.
Ventral/Incisional hernia – laparoscopic.
If a hernia is particularly large or has been present for a long period of time, an open procedure may be recommended over the laparoscopic option, however laparoscopic techniques are generally regarded as the 'gold standard' for many hernia procedures today.

Robotic surgery, as its name suggests, is surgery that is carried out by a robot. It's a minimally invasive surgery, which means it's capable of performing complicated surgical techniques through tiny incisions, leaving very little scar tissue behind. The robot is the tool here, just like a scalpel or a set of forceps would be a tool for a skilled surgeon. The surgeon will sit at the robot's controls, guiding the surgical instruments at the end of the robot's arms with high definition 3-D cameras.

Surgeons who perform procedures with these remote-controlled robots have compared it to miniaturizing their bodies and traveling inside their patient, giving them a closer look at the job they're doing without having to open the patient up. It sounds like an ideal situation, but it isn't all sunshine and roses. In order to give you a better perspective, here are the benefits and the downsides of robotic surgery:

Advantage #1: Smaller Incisions and Less Trauma
The nature of robotic surgery is less invasive, which means the patient experiences less pain and quicker recovery time. The surgical arms are often pneumatic, powered by compressed air and electricity to control the operation. The ‘hands’ of each arm, which hold each of the necessary surgical tools, are also smaller than human hands, which eliminates the need for large incisions. The surgeon remains in the operating room throughout the procedure. A team of nurses also monitors the patient during the process.

Surgeries that normally result in a week-long post-operative hospital stay can potentially become outpatient procedures. A liver resection, for example, would keep a patient hospital-bound for a week or more after a traditional procedure. Using a robot reduces that hospital stay to just one or two days.

Disadvantage #1: The Expense of Surgery
Surgery is an expensive proposition at the best of times. The high cost of installing a robotic surgery system can increase the cost of a surgical procedure. Surgical robots are costly to maintain, and their operation requires additional training, which is also expensive. Exact numbers are difficult to come by, but in general, a surgery utilizing a da Vinci surgery robot will cost between $3,000 and $6,000more than a traditional laparoscopic procedure.

Advantage #2: Higher Surgical Accuracy
Some surgeries — from orthopedic operations to neurological procedures — require a high degree of accuracy. One slip of the scalpel or misplaced set of forceps can cause damage or even result in the death of the patient. Robotic surgery robots aren't susceptible to the shaking or other strain-related movements a human surgeon might experience. If the controller’s hands are shaking, the machine’s software compensates for that movement, so it doesn’t affect the surgery.

Each robotic hand can rotate 360 degrees multiple times, something that human hands can’t do. This increases their range of motion. It is equipped with small joints that allow each arm to bend like a human wrist. This is an improvement over traditional laparoscopic tools, which are straight and unable to bend so they are harder to manipulate. It is also equipped with a 3D high definition camera, providing a better view of the surgical site than would be available otherwise, even during open surgery.
Disadvantage #2: Movement Latency
One of the most significant problems with robotic surgery is the issue of latency — the time it takes for the robot to carry out the surgeon's commands. It takes a few moments for the computer to communicate with the robotic arms. While this isn't an issue for routine surgeries, it makes it difficult for surgeons to respond quickly to problems that occur during the operation.

Advantage #3: Reduced Surgeon Fatigue
Surgeries, especially ones that take multiple hours, are exhausting for the attending surgeon. The team is on their feet for hours at a time, completing the surgery and attending to the patient. Surgery robots allow the surgeon to sit comfortably while operating.

This could help keep surgeons fresh and aware for the duration of their surgeries, preventing fatigue-related errors and reducing the potential for medical malpractice.

Robotic Surgery in the Coming Years
With the right expertise and technology, the advantages can eventually overcome the disadvantages. Communication latency is currently the biggest hurdle to overcome to allow this technology to hold a more prominent place in the medical community. Even if the cost of the procedure slows down the integration in hospitals, surgeries with robotic machines will continue to become more commonplace, allowing more precise microsurgeries with improved accuracy.