This type of procedure uses special surgical tools. Surgeons will use robotic arms to operate through very small incisions. These procedures can result in less scarring, reduced recovery times, less risk of infection, less blood loss, and reduction in stress response, compared to more invasive procedures. The robotic arms are able to perform surgical tasks with an increased range of motion. They also can filter out hand tremor. The special tools also translate the surgeons larger hand movements into smaller ones. This allows delicate work in small spaces.
Laparoscopic Cholecystectomy
Close-up view of laparoscopic tools used to remove the gallbladder (green structure).
This type of procedure is done to treat a variety of conditions.
Laparoscopic
surgeries that have been successfully performed using robotic techniques include:
A catheter is inserted into the uterus. A blue dye is injected to stain the uterine cavity. This will help make locating the fibroid(s) easier.
Several small incisions will be made. They are called keyhole incisions. Carbon dioxide gas will be passed into the area to expand the area. This makes it easier for the surgeon to see.
A small camera is passed through one of the incisions. The tool is called an endoscope. It lights, magnifies, and projects an image of internal organs onto a video screen. The endoscope is attached to one of three or four of the robotic arms.
The other two or three arms hold other tools. This may include dissectors, scissors, scalpels, and/or forceps. These tools are able to grasp, cut, dissect, and suture structures.
The surgeon sits at a console. The surgeon can see the abdomen image in a screen. Joystick-like hand controls and foot pedals will help to guide the tools. Another surgeon stays by you to adjust the tools as needed.
In some procedures organs or tissues are removed. The organ or tissue is dropped into a specimen bag. It can then be removed through one of the openings.
When the procedure is done, the tools are removed. The surgeon closes the incisions with sutures or staples, and applies a sterile dressing.
After Procedure
If an organ or tissue was removed, it may be sent to a lab. The lab will for examine it for any abnormalities.
How Long Will It Take?
It may last about 1-2 hours. The length depends on the type of procedure being done.
Will It Hurt?
Anesthesia prevents pain during surgery. Patients typically have pain and soreness during recovery. Pain medication will be given to relieve the discomfort. In the case of gynecologic procedures there may also be vaginal bleeding or discharge. 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
General:
Damage to neighboring organs or structures including the intestines
Infection
Bleeding
Anesthesia-related problems
Sometimes it becomes necessary during the procedure to abandon the robotic method and perform the surgery using traditional methods (eg,
traditional laparoscopic
or open surgery)
Specific to cholecystectomy:
Gallstones accidentally spill into the abdominal cavity
Specific to Nissen fundoplication:
Difficulty swallowing, belching, or vomiting
Narrowing of the esophagus requiring a subsequent procedure to dilate it
Talk to your doctor about complications specific to your surgery.
Average Hospital Stay
The stay is usually 1-2 days. It may be longer, depending on the procedure.
Postoperative Care
You will receive instructions on when and what you can eat, and how you need to restrict your activity. Depending on your procedure, your doctor will likely advise you to:
Take antibiotics to help prevent infection.
Avoid certain medications.
Resume normal activities (eg, taking daily walks) soon, to promote healing.
Limit certain activities, such as driving, walking up stairs, lifting, working, and engaging in sexual intercourse, for a period of time.
Outcome
Depending on your procedure, you should be able to resume regular activities within a few weeks. Based on evidence available to date, the risks of robotic surgery appear to be less compared to traditional forms of surgery.
Benefits of robot-assisted laparoscopic procedures over traditional laparoscopic procedures may include:
Duke University Medical Center (Reproductive Endocrinology and infertility) website. Available at:
http://medschool.duke.edu/
.
Accessed December 9, 2008.
Laparoscopic anti-reflux (GERD) surgery. Society of American Gastrointestinal and Endoscopic Surgeons website. Available at:
http://www.sages.org/sagespublication.php?doc=PI01
. Accessed July 18, 2006.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.
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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
