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Robotics in surgery: is a robot necessary? For what?

Authors
  • Ross, Sharona B1
  • Downs, Darrell2
  • Saeed, Sabrina M2
  • Dolce, John K2
  • Rosemurgy, Alexander S2
  • 1 Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL, USA - [email protected]
  • 2 Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL, USA.
Type
Published Article
Journal
Minerva chirurgica
Publication Date
Feb 01, 2017
Volume
72
Issue
1
Pages
61–70
Identifiers
DOI: 10.23736/S0026-4733.16.07235-7
PMID: 27849119
Source
Medline
License
Unknown

Abstract

Every operation can be categorized along a spectrum from "most invasive" to "least invasive", based on the approach(es) through which it is commonly undertaken. Operations that are considered "most invasive" are characterized by "open" approaches with a relatively high degree of morbidity, while operations that are considered "least invasive" are undertaken with minimally invasive techniques and are associated with relatively improved patient outcomes, including faster recovery times and fewer complications. Because of the potential for reduced morbidity, movement along the spectrum towards minimally invasive surgery (MIS) is associated with a host of salutary benefits and, as well, lower costs of patient care. Accordingly, the goal of all stakeholders in surgery should be to attain universal application of the most minimally invasive approaches. Yet the difficulty of performing minimally invasive operations has largely limited its widespread application in surgery, particularly in the context of complex operations (i.e., those requiring complex extirpation and/or reconstruction). Robotic surgery, however, may facilitate application of minimally invasive techniques requisite for particular operations. Enhancements in visualization and dexterity offered by robotic surgical systems allow busy surgeons to quickly gain proficiency in demanding techniques (e.g., pancreaticojejunostomy), within a short learning curve. That is not to say, however, that all operations undertaken with minimally invasive techniques require robotic technology. Herein, we attempt to define how surgeon skill, operative difficulty, patient outcomes, and cost factors determine when robotic technology should be reasonably applied to patient care in surgery.

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