Urology - Oncology, Laparoscopy, General Urology Mischel Neill - BHB MBCHB FRACS - Urology - Oncology, Laparoscopy, General Urology Urology - Oncology, Laparoscopy, General Urology


Robotic Surgery

There are steadily accumulating studies showing patient benefits from minimally invasive surgery.

These include

  • Less blood loss and a lower blood transfusion requirement
  • Less post-operative pain and pain-killer requirements
  • Shorter hospital stays
  • Quicker return to daily activity
  • Improving return to continence and potency

These benefits have been introduced while maintaining the established cancer cure outcomes of open surgery.

Robotic prostatectomy is very similar in strategy to the laparoscopic version of the operation. It is a form of minimally invasive surgery with technical refinements over standard laparoscopy that are related to the equipment used.

During the procedure the surgeon sits at an operating console a few meters from the patient. The controls and screen have been ergonomically designed for surgeon comfort. This in turn results in more natural movements and is therefore less physically tiring.

The robotic tools are introduced at the start of the procedure by the surgeon who has assistants that stay at the bedside throughout the operation. The robotic computer translates the surgeon's movements at the controls to instrument actions in real time. During this process it scales the movements and filters out tremor to maximize the accuracy of the instrument in executing it's intended task. All actions have to be initiated by the surgeon, the robot doesn't do anything independently. A variety of different instruments can be introduced during the case for various purposes. Throughout the procedure the robotic computer runs a continuous ongoing safety check system.

The advances established by laparoscopy such as small incisions and magnified vision are preserved but have been enhanced with robotic technologies.

The system uses a high resolution 3 dimensional camera which improves depth perception as opposed to the standard 2 dimensional view in laparosocopy. Robotic instruments have been designed with an "endowrist" that allows a much greater range of movement to that which can be achieved with standard laparoscopic instruments.

Robotic scaling and tremor filter optimize the accuracy of the instruments operating in a confined space with delicate nerve, blood vessel and support structures whose preservation may be important in protecting continence and erectile function.

The robotic surgical system was introduced more than 10 years ago and has an extensive well documented safety record throughout the world. Around 85% of all radical prostatectomies performed in the USA now use a robotic system with a similar trend developing in Western European countries and Australia.

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Urology - Oncology, Laparoscopy, General Urology Mischel Neill - BHB MBCHB FRACS Royal Australasian College of Surgeons Urological Society of Australia and New Zealand