Does robotic (Da Vinci) surgery have an advantage?
Of course, robotic surgical techniques differ from conventional open or laparoscopic techniques, and they have major advantages. Robotic operations are, in fact, one of the laparoscopic techniques. But the difference from laparoscopic operations is that the robot, with its instruments, carries out the movements of the human hand. In laparoscopic techniques the instrument cannot perform those movements. That is one difference.
What advantage does this difference give us? For example, in prostate cancer surgery, after the prostate has been removed, it plays a very important role in creating the anastomosis. In such cases, the anastomosis — that is, the connection between the bladder and the urethra — has to be made in a way that is very difficult to perform laparoscopically.
In addition, during this operation the so-called sphincter — that is, the valve mechanism — is not damaged, and the valve around the urethra stays in place, undamaged. After the operation the patient can urinate normally and hold urine. In other cases, that valve mechanism may be damaged. This is one of the advantages. That is, creating the anastomosis — carrying out those hand movements in reconstructive surgery — is of very great importance.
Besides that, during this operation all of the patient’s tissues, organs and blood vessels are seen very clearly, the chance of damaging them is very low, and this is very useful and helpful in performing complex operations. In addition, after such an operation patients not only have no pain but can even be discharged early. We discharge them on the third, fourth or, at most, the fifth day, and after that they can go on with their normal lives. And no hernia develops after such operations. The incision is small, and because of this patients have a short rehabilitation period, their return to everyday life goes well, and they get back to normal life in a short time.
There is just one aspect of robotic surgery that is, so to speak, a bit of a downside. Inserting the instruments into the body and connecting the robot to the instruments takes some time. But afterwards the operation proves its worth. By its name and by its importance, it shows that this operation is far superior.
Moreover, this points to a future trend — and it has already been done — where it may become possible to perform this operation remotely, over long distances. In China, for instance, they have done it: they operated on a patient for a condition from a distance of 5,000 kilometers, and it was successful. So this is already the future. In our time they have even begun applying artificial intelligence to these robots. With each operation, the robot learns how it should behave with which technique and with which problem. And as it learns, in the future it may even perform the operation by itself. That is a matter for the future. But this work is already under way.
In a word, this is a modern surgical method, and modernity is always relevant, and in such cases robotic surgery is considered superior. However, there are operations where it isn’t possible to use the robot: with large masses, with kidney tumors. Because a robotic operation always requires a certain working space. If there is a large mass, we cannot get that space. That’s why we are forced to resort to open surgery.
In every case, the doctor personally decides on the use of the robot: in which case it is possible, and in which case an open operation should be performed instead. That decision rests with the surgeon.
Complications such as pain, hernia, bleeding, infection and difficulty holding urine are possible after robotic surgery as well, and the time to discharge and recovery vary from person to person. The robotic approach is not necessarily better than other methods for every patient; the method is chosen individually after an examination.
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