Robotic Surgery: Applications, Limitations, and Impact on Surgical Education

Bishoy Morris, MBBCH (Hons)

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In This Article

Clinical Applications of Robotic Surgery

Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery,[1,2,3] thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden.[15] Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements ( Table 1 ).[1,2,3,12,13,14]

In a relatively short time, robotic procedures spanning the whole spectrum of surgery have been successfully executed ( Table 2 ).[1,3,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38] Initial results show that mortality, morbidity, and hospital stay compare favorably to conventional laparoscopic operations.[39] However, only a limited number of randomized, prospective studies that compare outcomes of robotic techniques with conventional methods exist.[40,41] More procedure-specific, randomized trials need to be performed before robotic surgery can find its way into everyday surgical practice.[19,42]

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