Doc Talk: Robotic surgery: not quite R2-D2

02/28/2012 5:00 AM

08/08/2014 10:09 AM

When people first hear about the robotics system, they may have visions of a weird robot-looking creature wheeling up to the operating room bed, sticking a metal arm into someone’s belly button and pulling out the offending organ.

Sounds like sci-fi, but it is what many patients are concerned about when I discuss the possibility of approaching their surgery using robotics. Hopefully, I can address some of the facts and fiction about robotic surgery so you will have a better understanding if you or a family member is in need of major surgery and approached with robotics as an option.

In the old days, most hysterectomies were performed through a large incision on the lower abdomen. The patient would be in the hospital for as long as four or five days, and the recovery at home could be as long as six to eight weeks. This typically is not the case any longer in our community, as most hysterectomies are either done vaginally, laparoscopically or robotically.

Laparoscopy solved many of the problems that open procedures posed. This type of surgery reduced hospital stay and, typically, the return to work or normal activities was quicker. A camera is used, and several instruments are inserted through small incisions in the abdomen to perform the surgery. The problem with laparoscopy was that women with a very large uterus or a history of multiple surgeries were not good candidates and often had their hysterectomy through a large incision.

Robotics, or the da Vinci system, has changed gynecologic surgery. Robotic surgery has the same advantages of laparoscopy — reduced hospital stay (often less than 24 hours) and quicker return to work. However, it also enables the surgeon to perform minimally invasive surgery in patients that typically are not good candidates for laparoscopy, such as those who have a very large uterus or a prolapsed organ.

The major difference with robotics is the ability of the instruments to turn in more than one direction, like the human hand. The instruments are controlled by the surgeon (not the robot!) from a console after the surgeon has placed the instruments through small incisions in the abdomen. This multidimensional movement is what allows surgeons to tackle more technically challenging procedures. Robotic surgery also is being used with greater frequency by urologists, colorectal surgeons, cardiologists, and ear, nose and throat specialists to perform surgeries that previously required long hospital stays and significant time out of work.

There are certainly a variety of reasons for a surgical approach to gynecologic problems, and only a qualified physician can help you determine the right choice for you. If you are interested in learning more about the robotic approach for surgery, visit and search “robotic surgery.”

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