Definition

A doctor guides small robotic arms through several tiny keyhole incisions. This allows for greater range of movement than a doctor's hand.

Reasons for Procedure

Robot-assisted surgery is considered for procedures that:

    
  • Require precision
  • Do not require open access, especially laparoscopic procedures
  • Performing surgery in this way may result in:

        
  • Less scarring
  • Reduced recovery times
  • Less risk of infection
  • Less blood loss
  • Reduced trauma to the body
  • Shorter hospital stay
  • Faster recovery
  • Many types of surgery, including pediatric surgery, can now be done with the assistance of a robot, including:

    General:

        
  • Adrenalectomy—removal of adrenal gland
  • Cholecystectomy—removal of the gallbladder
  • Gastric bypass—procedure to treat obesity and reduce the size of the stomach
  • Heller myotomy—procedure on the lower esophageal sphincter
  • Nissen fundoplication—treatment for severe heartburn
  • Colorectal surgery—surgery of the colon
  • Appendectomy—removal of the appendix
  • Hernia repair
  • Chest:

        
  • Esophagectomy—removal of the esophagus
  • Thymectomy—removal of the thymus gland
  • Mediastinal tumor resection—removal of tumors in the chest cavity
  • Lobectomy—surgical removal of a lung
  • Heart:

        
  • Coronary artery bypass surgery
  • Atrial septal defect repair
  • Mitral valve repair
  • Gynecologic:

        
  • Hysterectomy —removal of the uterus
  • Myomectomy —removal of uterine fibroids
  • Urologic

        
  • Pyloroplasty
  • Nephrectomy—removal of the kidney
  • Radical prostatectomy—removal of the prostate
  • Cystectomy—removal of the bladder
  • Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have robot-assisted surgery, your doctor will review a list of possible complications, which may include:

        
  • Damage to nearby organs or structures
  • Infection
  • Bleeding
  • Anesthesia-related problems
  • The need to switch to traditional surgical methods such as traditional laparoscopic or open surgery
  • Some factors that may increase the risk of complications include:

        
  • Pre-existing heart or lung condition
  • Increased age
  • Diabetes
  • Obesity
  • Smoking
  • Excessive alcohol intake
  • Use of certain medications
  • What to Expect

    Prior to Procedure

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

        
  • Physical exam
  • Blood tests
  • Electrocardiogram (EKG)
  • Chest x-ray
  • Ultrasound
  • CT scan
  • MRI scan
  • Leading up to the surgery:

        
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Take antibiotics if instructed.
  • Follow a special diet if instructed.
  • Shower the night before using antibacterial soap if instructed.
  • Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.
  • Anesthesia

    Depending on the type of procedure that you have, you may be given:

        
  • General anesthesia—blocks pain and keeps you asleep through the surgery
  • Local anesthesia with sedation—just the area that is being operated on is numbed, given as an injection
  • Description of the Procedure

    Keyhole Incisions

    factsheet image

    Keyhole incisions are placed in preparation for a robot-assisted surgical procedure.

    Copyright © Nucleus Medical Media, Inc.

    Several small keyhole openings will be cut in the skin near where the surgery will take place. In most cases, a needle will be used to inject carbon dioxide gas into the surgical area. This gas will make it easier for the doctor to see internal structures. Next, a small camera called an endoscope will be passed through one of the incisions. The camera will light, magnify, and project an image of the organs onto a video screen. Then robotic arms holding instruments for grasping, cutting, dissecting, and suturing will be inserted through the holes.

    While sitting at a console near the operating table, the doctor will use lenses to look at a magnified 3D image of the inside of the body. Another doctor will stay by the table to adjust the camera and tools. The robotic arms and tools will be guided with joystick-like controls and foot pedals. Lastly, the tools will be removed and stitches or staples will be used to close the area.

    How Long Will It Take?

    Usually 1-2 hours or less

    How Much Will It Hurt?

    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications. You may also feel discomfort from the gas used during the procedure. This can last up to 3 days.

    Average Hospital Stay

    This procedure is done in a hospital setting. The usual length of stay is a few days. Your doctor may choose to keep you longer if you have any problems.

    Post-procedure Care

    While you are recovering at the hospital, you will:

        
  • Be encouraged to walk with assistance soon after surgery.
  • Receive guidelines on what you should eat and what activities you can do. Depending on your procedure, you should be able to go back to your normal activities in a few weeks.
  • Participate in any physical therapy or rehabilitation.
  • Call Your Doctor

    It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

        
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
  • Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain
  • Constipation or diarrhea
  • New or worsening symptoms
  • If you think you have an emergency, call for medical help right away.