Robot-Assisted Surgery—Overview

Prior to Procedure

Depending on the reason for your surgery, your doctor may do the following:

• Physical exam
• Blood tests
• Electrocardiogram
• Chest x-ray
• Ultrasound—a test that uses sound waves to visualize the inside of the body
• CT scan—a type of x-ray that uses a computer to create images of the inside of the body
• MRI scan—a test that uses magnetic fields and radiowaves to create images of the inside of the body

The days before and the day of your procedure, you will:

• Review your medications with the surgeon; you may need to stop taking some drugs
• Follow a special diet, if recommended by your surgeon
• Take antibiotics, if prescribed by your doctor
• Shower the night before your procedure using antibacterial soap, if your doctor asks you to
• Need to arrange for someone drive you to and from the procedure, and for help at home afterwards
• Eat a light meal the night before
• Not eat or drink anything after midnight unless otherwise instructed by your doctor
• Need to wear comfortable clothing

Anesthesia

General or local with sedation

Description of the Procedure

Small "keyhole" incisions being placed in preparation for a robot-assisted surgical procedure

© 2008 Nucleus Medical Art, Inc.

The surgeon cuts several small (approximately one centimeter) “keyhole” openings in the skin near where the surgery will take place. In most cases, a needle is used to inject carbon dioxide gas into the area around the surgical site, making it easier for the surgeon to see internal structures.

The surgeon passes a small camera (endoscope) through one of the incisions, which lights, magnifies, and projects an image of internal organs onto a video screen for the surgeon to see. The endoscope is attached to one of three or four robotic arms that form part of surgical system. (There are currently two robotic surgical systems approved by the Food and Drug Administration for use in the United States: the da Vinci Surgical System and the ZEUS Robotic Surgical System.) The other two or three arms hold other instruments such as dissectors, scissors, scalpels, and/or forceps. These instruments are able to grasp, separate, cut, and sew tissue during the operation.

While sitting at a console several feet away from the operating table, the surgeon looks through lenses at a magnified three-dimensional image of the inside of the body. Another surgeon will stay by the patient during the procedure, where he can adjust the camera and instruments as needed.

With joystick-like hand controls and foot pedals, the surgeon at the console guides the movement of the robotic arms and surgical instruments. By filtering out hand tremor and translating the surgeon’s larger hand movements into smaller ones, the robotic arms are able to perform surgical tasks with increased range and dexterity than would be possible using traditional surgical techniques.

After the endoscope and other instruments are removed, the surgeon closes the incisions with stitches or staples, and applies a sterile dressing.

After Procedure

Depending on the reason for the procedure, some of the tissue that was removed may be sent to a pathologist for examination.

How Long Will It Take?

Usually 1-2 hours or less, but this depends on the type of procedure being done.

Will It Hurt?

Anesthesia prevents pain during surgery. Patients typically experience pain and soreness during recovery, but receive pain medication to relieve the discomfort. You may also feel bloated or have pain in your shoulder from the gas used during the procedure. This can last up to three days.

Possible Complications

• Damage to neighboring organs or structures
• Infection
• Bleeding
• Anesthesia-related problems
• Open surgery—sometimes it becomes necessary during the procedure to abandon the robotic method and perform the surgery using traditional methods

Average Hospital Stay

A benefit of robotic surgery over traditional surgery is that it permits shorter stays in the hospital. Depending on the procedure, most patients usually require only a few days of hospital care.

Postoperative Care

If all goes well, you will likely be encouraged to get up and out of bed the same day of or the day following your procedure. You will receive instructions on when and what you can eat, and to what extent you need to restrict your activity. You will to limit your activities for the first days or weeks of your recovery.