I trained in New York on the Da Vinci robotic system. In South Korea I extended my robotic skills to the Single Incision Surgery (SILS) Technique learning from Professor Kim at Yongsei University. Unlike conventional laparoscopy, the robotic approach has significant advantages including:
- Enhanced vision – 3D high definition vision allows amazing detailed definition of anatomy enabling precise surgery to be performed.
- Wristed instruments – the ends of the instruments used for the operation are wristed. This means the ends are flexible and can move about like bending your wrists. This allows for operating in tight confined spaces, not otherwise possible with laparoscopy with its fixed instrumentation.
- Better hand eye co ordination Co ordination of all four operating instruments under my direct control. This contrasts with conventional laparoscopy, where I can only hold two of them, the others being held by an assistant surgeon. In that instance I have to both concentrate on operating and coordinating the assistant surgeon’s movements. With the robot I control it all myself.
- Better ergonomic positioning. Sitting down to control the instruments, my posture, especially in long operating cases is more relaxed. This reduces the possibility of tiredness and discomfort, which comes from standing and moving about when using conventional laparoscopy.
In my experience of over 130 cases of robotic surgery, I have found that the patients appear to have:
- Shorter hospital stay
- Less blood loss
- Less pain
- Fewer complications
- Faster return to normal activities
I now routinely offer robotic surgery for
- removal of severe endometriosis,
- removal of fibroids
- sacro colpopexy for prolapse
- reversal of tubal sterilisation
- freeing up of severe adhesions
Where appropriate, use of the SILS technique additonally enhances the recovery and cosmetic outcomes for the patient.
In many patients, despite major surgery, their recovery is so good that they can be disharged home the following day. For some, same day discharge can also be achieved, even for hysterectomy.