What is robotic-assisted surgery?

da Vinci robotic systemUC Davis Health gynecologic surgeons perform minimally invasive procedures for fibroids, gynecologic cancers, endometriosis and other conditions using robotic surgical systems. Surgical robots, with precision-guided arms and video cameras, are completely controlled by trained surgeons, who manipulate the mechanical arms from an operating-room console next to the patient’s bed. Robotic-assisted surgery is a minimally invasive option that requires several small incisions rather than the larger incisions required for traditional “open” procedures, which can help reduce blood loss and postoperative recovery time.

How does robotic-assisted surgery work?

da Vinci hand controlsSpecial equipment used during robotic-assisted procedures includes an operating console for the surgeon, precision-guided robotic arms that are inserted through a few small incisions and a small video camera that provides magnified, 3D images of the surgical site. The camera enables surgeons to see blood vessels, nerve bundles and organs (such as the bladder, rectum and ureters) adjacent to the operating area. The robotic arms, with full 360-degree rotation capabilities, allow surgical instruments to move with precision, flexibility and a range of motion that cannot be accomplished with other options.

Robotic-assisted procedures are usually done while the patient is under general anesthesia. Most patients experience only a small blood loss and blood transfusions are uncommonly needed. Patients who undergo minimally invasive surgery typically spend zero to two nights in the hospital. They are usually discharged when they are able to tolerate regular food, walk without assistance and have pain that can be controlled with medication. 

What are the benefits to patients?

Patients typically experience significantly less pain, less blood loss and quicker recovery times than those undergoing conventional “open” procedures. Studies also suggest that the robotic-assisted system provides surgeons with a superior tool that allows for the precise removal of lymph nodes during cancer operations, when compared to traditional open or other minimally invasive approaches. The robotic system also allows surgeons better visualization of the anatomy, which is critical when working around delicate and confined structures like the bladder, blood vessels and other internal organs. This allows surgeons to perform complicated surgeries and helps overcome challenges associated with scar tissue.

Why is there less blood loss with robotic-assisted surgery?

The enhanced, 3D view with magnification can allow the surgeon to see blood vessels even more easily than is possible with open surgery. This superior visualization, along with precise movement of the surgeon-controlled robotic arms, improves the ability to expose and control blood vessels adjacent to the surgical field.

What are the risks of robotic-assisted surgery?

incision comparison open surgery vs. robotic surgeryRobotic-assisted surgery is major surgery performed through small incisions. It has the same kinds of risks as open surgery, including injuries to intra-abdominal organs. There also are risks of medical complications such as stroke, heart attacks and blood clots in the legs. General anesthesia is generally very safe, but occasionally there are complications with this as well. Smaller incisions usually mean less pain and discomfort compared to large abdominal incisions. Robotic and other minimally invasive surgeries can minimize the risks of wound infections, pneumonia and blood clots in the legs, because only small incisions are required. The benefits of any surgical procedure cannot be guaranteed. Pre-operative assessment of a patient’s overall health is a key element in every surgical decision at UC Davis Health. Successful outcomes depend on both the patient and the procedure. Patients should always discuss all treatment options with their physician to understand the risks and benefits.

What are the patient criteria for robotic-assisted procedures?

Not all patients are suitable for robotic surgery. Severe medical problems and/or advanced age may mean that the patient cannot tolerate the special positioning and length of the procedure. Severe obesity is a common limitation, although robotic surgery can sometimes be successful when standard laparoscopy is not feasible. Severe intra-abdominal scar tissue due to previous surgery may prevent a minimally invasive approach. Your surgeon will discuss treatment options and help you decide the best course of action.

What about follow-up care for robotic-assisted procedures?

Follow-up care depends on the condition being treated. Most patients who undergo a robotic-assisted procedure usually have one or two post-operative visits, unless there are complications. If the patient has cancer, follow-up visits to monitor the patient for a possible recurrence is standard care. Patients may or may not need additional cancer treatments, depending on the pathology report following surgery. Your physician will develop a post-operative action plan for you.