Once the stuff of science fiction, robotic surgery is now used in hospitals across the world for a wide variety of procedures. Across several common procedures, some research has found that robotic surgery can improve outcomes in areas such as blood loss, complications, and recovery times, compared to open and some laparoscopic surgeries.
Robotic procedures have been game changers in minimally invasive care, and innovative surgical systems have been crucial. Robotic surgery isn’t performed by a machine; a specially trained surgeon uses advanced medical technology to streamline the surgical process. The end goal is to increase safety, reduce complications, and improve patient outcomes. By reducing surgical trauma and increasing precision, robotic surgery can help pave the way for predictable, reproducible results.
Although robotic surgery has made impressive advances over the past two decades, there is much more to be done. As minimally invasive care continues to advance, researchers are finding new ways to help surgeons do more for patients.
How robotic surgery works
The first commercially viable robotic surgical system was developed in the late 1990s by Intuitive. Intuitive’s systems have gone on to become the most advanced and widely used in the world. Four generations of its pioneering da Vinci system have so far been used in more than 10 million procedures.
Intuitive’s robotic surgical systems enable surgeons to use a console, precisely guiding surgical instruments inside the patient’s body. The surgeon’s hand movements are translated in real time to the instruments, which are situated on a cart beside the patient. The instruments are small, nimble, and have a greater range of motion than the human wrist and hand, helping to enable surgical precision in moments that matter.
In contrast to open surgery, which typically requires a large incision, robotic surgery involves one or more very small incisions to insert the robotic arms. One of the arms has a camera that feeds high-quality 3D video to the surgeon’s console.
“I remember distinctly when I first sat at the console,” says Tanuja Damani, a general surgeon at New York University who first began using the da Vinci system in 2011. “I realized right away that this was the future of surgery. But there was tremendous skepticism early on.”
Dr. Damani and other early adopters saw the potential of this approach. Their vision, perseverance, and mentoring have smoothed the way for those who have followed.
Take Amanda Pysher, a young bariatric and general surgeon with Surgical Consultants of Northern Virginia, who was first introduced to robotics during her residency and fellowship. Unlike Dr. Damani, Dr. Pysher has benefited from a robust network of mentors, who’ve helped her as she’s learned the ropes of using the da Vinci system. She’s become so comfortable with the system that three years ago she focused her practice on robotic surgery. She now mentors other surgeons who are in the process of learning robotic surgery.
“I think it has been easier for me to transition to robotics than the first adopters years ago,” she says. “It’s one of the reasons I feel so strongly about mentoring. I want to be able to give back and help others the way that the mentors above me helped me. We’re helping people live longer for their families and their friends. I just can’t think of any other surgery which has a bigger impact than that.”
Robotic surgery’s impact on patients
For both Dr. Pysher and Dr. Damani, the goal is to do more for their patients. One such patient is Jennifer Luebke. Last year, after struggling with her weight for decades, Luebke decided to have a robotic bariatric surgery with Dr. Pysher.
That decision stemmed largely from her sense that her weight increased her long-term health risks. “I want to be able to grow old and be a grandmother, and I really didn’t see that in my future,” Luebke says. “I really was concerned. This is the one thing that has completely changed my life.”
As an emergency room nurse, Luebke was reluctant to undergo traditional open bariatric surgery – she’d seen patients who’d had to deal with complications. But as her weight increased and her health problems grew, she decided that robotic surgery might reduce the risk of complications.
Her decision paid off. After the procedure, she spent the night in the hospital and was discharged the next morning.
As the technology continues to advance, more and more surgeons and hospitals are coming on board.
The number of worldwide robotic procedures more than doubled between 2012 to 2020. A study published two years ago in JAMA Network Open analyzed records from 73 hospitals in Michigan, finding that 8.7 percent of surgeons performed robotic general surgery in 2012; by 2018, that number had jumped to over 35 percent.
“We are turning the skeptics into believers,” Dr. Damani says. “The shared sense of purpose of the robotics surgery community now is something that is so refreshing.”
Total da Vinci Practice*
*Total da Vinci Practice refers to the transferable value of robotic-assisted surgery with a da Vinci system across procedures in a surgeon’s minimally invasive practice. It is at the surgeon’s discretion to determine when a patient is a candidate for minimally invasive surgery and whether robotic-assisted surgery with a da Vinci system is an option.
