Advantages & Disadvantages of Robotic Surgery

24 Feb Advantages & Disadvantages of Robotic Surgery

First approved in the USA two decades ago, da Vinci robotic surgery has now become more commonly available in Australia. It is the only available robotic surgery system in Australia so far, although a few other systems are coming onboard soon. More than 7 millions procedures have been performed using the da Vinci robots, most commonly hysterectomies and prostatectomies.

Advantages of Robotic Surgery

Being a minimally invasive surgical option, the advantages of less bleeding and infection, less pain and quicker recovery over traditional open procedure are obvious. These are similar advantages of conventional non-robotic laparoscopic surgery using ‘straight stick’ instruments. However, there are some advantages of robotic surgery over conventional laparoscopic surgery that may make a difference to surgical outcome.

These are:

• Magnified (up to 10x) High Definition (HD) 3-D view of operating field
• A wrist at the end of laparoscopic instrument (EndoWrist) mimic the movements of the human wrist – in fact it exceeds the natural range of motion of the human hand
• Natural hand tremor is filtered out by the robot software to allow tremor free instrument movement and camera view
• The surgeon has complete control of all the robotic arms – instruments and camera without relying on an assistant
• Less manipulation of incision sites on the abdominal wall – through fulcrum points and wristed instruments – reduces local trauma and potentially post-operative pain

These technological advantages allow the surgeon to perform more complex surgeries – previously thought to be performed only through larger open incision – laparoscopically. For example in gynaecology, robotic surgery allows laparoscopic hysterectomy in larger uterus over traditional laparoscopic surgery. It also allows minimally invasive surgery in more overweight patients and therefore reducing their overall risk of surgery.

Disadvantages of Robotic Surgery

The main disadvantage of robotic surgery is it is an expensive technology. Robotic surgery is not as accessible as conventional laparoscopic surgery due to availability and cost. Currently, most robotic surgery systems in Australia are installed in private hospitals. While many private health insurance companies cover the additional cost of robotic instrumentations, others do not cover this extra cost. However, cost is gradually coming down over time as the technology becomes more available and established. Other robotic surgery systems are also becoming available. Competition will hopefully bring cost down further, making robotic surgery more available and more accessible than before.