What is Robotic Surgery?
Robotic surgery is a laparoscopic (keyhole) surgery performed with the aid of a surgical robotic system. Currently, there is only one brand of robotic surgical system, the Da Vinci Surgical System. The first system was launched in 1999. The technology has undergone constant improvements and refinements. Now it is truly state of the art medical technology representing the best there is to offer for advanced surgery.
What is the difference between "normal" or conventional laparoscopic surgery and robotic surgery?
The surgical robotic system allows for much more dextrous surgical instruments to be used. Each robotic instrument is “wristed” as if there is a miniature hand operating inside. In fact the instrument has more freedom of movement than the human hand. Conventional laparoscopic instruments only operate in a purely “scissor-like” open/close fashion.
In addition, the robotic camera system gives the surgeon a 3D view unlike usual laparoscopic camera systems which is only a 2D view. This, plus the better instruments allows for a more precise dissection during surgery.
Is a surgeon actually needed at the operation? Is it a robot (computer) doing the work?
The surgeon is actually controlling all the instruments via a “console” where he/she directs the movement of the instruments with his/her wrist, hands and fingers. The robotic system does not employ any “artificial intelligence”, the surgeon is making all the decisions and controlling how and where to cut during the surgery.
Is the robotic system “necessary” in colorectal surgery?
With conventional laparoscopy, we can perform almost all types of colorectal surgery. However, for some select cases, the robotic system give the surgeon an advantage to do the types of cases that are more difficult with conventional laparoscopy. According to scientific studies, for treatment of rectal cancer, robotic surgery have a higher success rate (able to complete the whole operation though the keyholes only), lower risk of pelvic nerve injury (affecting urinary and sexual function).
What kinds of cases are suitable for robotic surgery?
Most cases where part of the large bowel (intestine) needs to be removed e.g. cancer are suitable. The robotic system will make the most difference in cases where part or whole of the rectum needs to be removed e.g. rectal cancer. It is particularly good in cases where the diseased part is near the anus, often times enabling the surgeon to selectively remove the diseased part and preserving the function of the anus.
Why is robotic colorectal surgery relatively uncommon?
Expense. It is more expensive to use the system to do the operation compared to conventional laparoscopy.
Expertise. For colorectal surgery, it takes a surgeon a long time to master the operation using the robotic system to the point that he/she can actually do the case as good as or better than conventional laparoscopy. Unless the surgeon has fully mastered the robotic system, he/she may not do the operation any better with the robot than with conventional laparoscopy. The situation is not the same for other types of surgery e.g. prostate or gynaecology, where the surgeon with the aid of the robot, can easily exceed their capability with conventional laparoscopy.
Availability. Unfortunately because the system is very expensive, not all hospitals have equipped their operating theatres with the robotic system.
If you are looking for a Singapore Colorectal Surgeon, contact Dr Ng today.
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