January 30, 2023
The Myths and Facts of Robotic Surgery
The timeline for robotic surgery, as with many things in medicine, goes from being considered something to be skeptical of – to today – its use as the standard of care for many surgical procedure types. Though the notion of robot-assisted surgery has origins that trace back over half a century, its use in practice has been solidly in place since the 1980s. However, misconceptions about robot-assisted surgery's abilities (or lack thereof) still exist today. Below are four commonly held myths about robot-assisted surgery and the facts to help dispel them.
Myth: A Robot Performs Robotic Surgery Procedures
FACT: The more accurate description for this type of surgery is robot-assisted because the truth is that the surgeon is in control for the entire duration of the surgical procedure. Robot-assisted surgery helps surgeons extend their visual and physical capabilities; it does not replace them. The surgeon is present and actively always controlling robotic instruments during a robot-assisted procedure. Robot-assisted surgery magnifies the surgical area for the surgeon, and the tools used are smaller and can be moved with a greater range of motion than a human hand. All these benefits culminate in the ability to operate on patients in a way that human hands and eyes simply cannot.
Myth: Robot-assisted surgery is a "new" technique that hasn't been used long enough to prove its safety and effectiveness.
FACT: Robot-assisted surgery has been in use for decades. For example, 60,000 surgeons worldwide have been trained in robotic surgery using the da Vinci system (as utilized in my practice). More than 10 million surgical procedures have been performed using da Vinci systems. I have performed, proctored, and taught more than 3500 da Vinci robotic urological procedures at my practice – Urology Cancer Specialists. The mechanical instrumentation used in robot-assisted surgery is only as good as the surgeon's skill, training, and experience.
Myth: Regarding surgery, one incision is better than multiple incisions.
FACT: Research indicates that open procedures through one large incision that must cut through significant amounts of skin and muscle (while necessary for certain patients and condition types) can increase the risk of bleeding, infection, postoperative complications, and recovery time. In many cases, minimally invasive, robot-assisted surgery can be accomplished without large incisions and without the need to cut through delicate tissues and muscles. So, although the same procedure may need to be performed through more than a single tiny incision, this approach often remains preferable to singular large incisions.
Myth: Surgeons who use robot-assisted surgical techniques are at the leading edge of surgery.
FACT: While it may be true that a surgeon who uses robot-assisted technology to treat certain medical conditions is an advanced expert in the field, it isn't always. Patients considering robot-assisted procedures for their surgical needs should always ask crucial questions of the surgeons recommending and employing these types of technology. How and where was the surgeon trained? Are they an expert in robot-assisted surgery for the specific procedure you need to have done? How many of the exact procedures you need has the surgeon performed? How long has the surgeon been using the particular type of robot- assisted technology they recommend for you? This is by no means an exhaustive list of questions to ask, but it is an excellent place to start. As previously mentioned, robot-assisted technology is a tool in the hands of a surgeon.
It might be surprising to learn that most complex surgical systems take over two decades to be approved by the Food and Drug Administration for use on patients. Yet, the approval of robotic surgical technology took about half that time. The reasons for the accelerated approval were compelling and unmistakable insofar as the outcomes that patients experienced undergoing a robot-assisted procedure versus open surgery. Robot-assisted surgery has come a long way in a relatively short period – medically speaking. There is much more innovation on the horizon, which promises to benefit patients with a wide range of diseases even more in the future.