Dr. Antonio Alberola, Head of General Surgery and Digestive System Service of IMED Valencia, as well as coordinator and chief of Robotic Surgery da vinci Xi, give us the key to understand in what consists robotic surgery and what are the advantages compared to previous surgical techniques, in a recent interview of Sandra Gallarte in Gestiona Radio.
The robotic system da Vinci is, nowadays, the only available technology to access to a real robotic surgery.
By da Vinci robotic surgery we understand the last evolution of minimally invasive surgery, after laparoscopy, in which the surgeon doesn’t operate with his hands, but manipulating a robot in the distance, while he is seated in a console installed in the OR. The computerized system turn the hand’s movement in pulses that are channeled in robotic arms.
But, is it the robot who operates? Evidently no, and is Dr. Alberola who remark that “who operates is an expert surgeon that is experienced, and the only thing that the robot do is to communicate the movements of the surgeon. The robot doesn’t operate by his own”. And continues saying, “to make it trough the robotic system da Vinci suppose to minimize mistakes to the maximum. We avoid physiological shaking that all human being have, including most experienced surgeons, making millimeter movements with total accuracy”.
The robotic system da vinci Xi is formed by a surgical console, patient’s cart and the vision tower. The console has all the control center. Through the console the surgeon controle the optic fiber and equipment through two manipulators and pedals.
Patient’s cart is the operative component of da Vinci system and is formed by four mobile changeable arms, intended to support optic fiber, and equipment of 5 mm till maximum 8 mm.
The vision tower has the central unit of image elaboration.
“The surgeon operates in a console that give him a binocular view in 3 dimension and with an increase of 10x, it seems you are inside the patient”, tell us Dr. Alberola. “in robotic surgery clamps are articulated, they aren’t straight as in laparoscopic surgery, articulating the same movements than the surgeon’s hand, and even superior, which give a higher manoeuvrability that let him reach the most difficult access places and make the most diffcult sutures”.
New robotic surgery applications
Apart from the main procedures indicated in specialties as urology, gynecology and digestive system, in which is highly proved the efficiency of robotic surgery compared to other surgeries, there are new specialties in which is also showed the efficiency of robotic surgery, specially in otolaryncology and cardiology.
As Dr. Alberola says, “nowadays da Vinci is used, successfully, in otolaryngology, basically for difficult cases of tongue or hypopharynx tumours that need a very functional and millimetrical surgery. Also apnoeas, yet anecdotal, but we don’t know till where it can arrive… in cardiac surgery, where they have done already valvular replacement with the robot, although everything is still in process”.
Robotic surgery and postoperative
Recovery is very important for the patient. As performed studies show, robotic surgery reduce hospitalization time and allows a faster return to normal life, apart from producing in the patient less postopertive pain.
In this sense, Dr.Alberola indicate us that patient’s recovery is similar to the laparscopic surgery one, but improved, because the robot avoid involuntary movements that produce lessions and traumas, reducing bleeding risk in the intervention and pain during recovery process and, so, hospitalization is shorter and patient is discharged before”.
At the same time, insurances realise that there is a scientific evidence that robotic surgery is good for patients and, as this, is interesting to offer in their cover and services portfolio, so companies include it more and more in their policy cover.
Robotic surgery grows exponentially each year and now, with its inclusion in the companies cover portfolio, is predicted a considered increase of prostate, colon an cervix robotic surgeries, as well as new robotic surgery techniques applied to different pathologies.
