Robotic Surgery

What is a surgical robot?

Robotic surgery is one of the most important innovations in the field of medicine since the beginning of the current century. The basis for this is surgical robots, and the most advanced technology in this regard is found in the Da Vinci robotic system. Today, 8.5 million surgeries have been performed in this system all over the world. In this technology, surgeries are performed through robotic arms that can imitate hand movements directed by experienced surgeons. Robotic surgery, like laparoscopic surgery, is a closed surgery technique, and the surgery is performed through channels called “ports” placed in the abdomen through small incisions, as in laparoscopic surgery.

What parts does the Da Vinci Robot consist of?

The da Vinci system consists of 3 parts: surgeon console, patient console and monitor. The surgeon console is the part where the surgeon sees the operating field in 3D and also directs the robotic arms. The patient console includes robotic arms, and the arms are under the control of the surgeon inside the patient. In the last part, the monitor part, the second surgeon at the patient’s bedside sees the operation field through the monitor and helps the surgeon at the console.

What advantages does robotic surgery have?

The surgeon can see the operation area in 3D and enlarged form on the console, and thus can evaluate the tissues much more closely and clearly.

The arms of the robot are articulated (endowrist technology), and it can perform the wrist and finger movements of the surgeon on the console simultaneously on the patient without shaking. In this way, tissues can be separated from their anatomical plans and vascular structures can be connected at more correct angles. As a result, the amount of bleeding is very low.

In which surgical techniques are robotic surgery used in Urology?

1: Radical prostatectomy: The surgery in which robotic surgery is most commonly used in Urology is “radical prostatectomy” for prostate cancer. In this surgery, robotic arms easily reach the prostate, which is located deep and in a narrow area, and with the ease provided by the 3-dimensional and enlarged view, it contributes positively to the preservation of the anatomical structures that enable urine retention and erection of the penis. In this particular surgery, the most important advantage of robotic surgery over the open technique is that the time taken for complete urine retention is shorter and blood loss is less in the robotic technique. Partial nephrectomy: It is a surgery to remove only the cancerous part in order to protect the kidney in kidney cancers of a certain size. In this technique, after the vessels of the kidney are closed for a limited time and the blood supply to the kidney is stopped, the cancerous part of the kidney is cut out with robotic scissors. Then, the surface where the cancerous tissue was removed is stitched with the help of robotic needle holders to prevent urine leakage. Finally, the vessels of the kidney are opened and the kidney is checked for bleeding.

2:Pyeloplasty: This surgery is performed to treat the stenosis in the urinary tract coming from the kidney . After the narrow part is cut and removed, both ends of the urinary tract are joined with stitches to make a urine-tight seal. In this surgery, the above-mentioned superiority of the Da Vinci robot in stitching makes the work of the surgeon and therefore the patient easier.

3:Retroperitoneal lymph node dissection: For patients with enlarged lymph nodes in their abdomen due to testicular cancer, after chemotherapy, requires a delicate surgical technique. The 3D view of the da Vinci robot, especially with magnification is very useful here.

In addition to these surgeries, where robotic surgery is most commonly used, radical cystectomy to remove the bladder in bladder cancer is used in adrenal gland surgeries and many other urological surgeries.