Conventional laparoscopy or Robotic surgery

For keyhole surgery, conventional laparoscopy has been long used for performing major surgery. The advantages it offers over the traditional “big cut” approach is well documented and understood. However, it does have its limitations. In cases where there is a lot of scarring ( adhesions), a large mass in the pelvis or in very long operations, one may have to forgo its use and revert to the traditional big cut.

Robotic surgery is the “new kid on the block”. Using a robot to control the operating equipment including the telescope remotely, has allowed the surgeon to move away from the operating table and instead sit on a console to undertake the operation. This results in

• less tiredness in long operations due to a better ergonomic position for the surgeon
• controlling all equipment simultaneously leads to better hand eye co ordination
• very high vison resolution provdies great clarity
• use of 3 D vision gives perception of depth
• use of wristed instruments allow greater maneuverability

All these leads to an improved ability to operate in difficult conditions including tight small spaces that conventional laparoscopy can fail to achieve. Furthermore, the operating equipment once inserted are kept in for the duration of the operation with minimal requirements for changing. In laparoscopy however, one constantly has to remove and reinsert equipment throughout the procedure. This can lead to an increase risk of damage by the process of instrument changeover. Even though this risk is small, nonetheless it is greater than with robotic surgery.

Despite the advantages robotic surgery has, conventional laparoscopy is still the standard procedure for the majority of operations performed. This is due to the simplicity and ready availability of the equipment. Furthermore, not all operations require the complexity of the robot.

I use both techniques and will always undertake the one that I believe is most suitable to the individual’s needs after careful discussion.