Labette Health | Summer 2019 3 incisions that may result in less postoperative pain, reduced blood loss, less need for blood transfusions, and a potentially faster recovery and return to normal activities. Robotic prostate surgery One of the most effective treatments for prostate cancer is the surgical removal of the prostate and surrounding cancerous tissues. Urologists who treat prostate cancer generally use one of two approaches: open surgery (requiring a large incision and typically longer hospital stay) or minimally invasive robot- assisted laparoscopic surgery. Regardless of the method, the surgeon’s goal is the same: to remove the prostate gland and cancer with minimal irritation of surrounding structures. The urologist’s goal is to cause as little damage as possible to the nerves surrounding the prostate that help control the urinary sphincter muscle and sexual function. The 3-D enhanced vision provided by the robotic camera lens allows urologists to more accurately identify these structures and spare them from injury. The benefits of robot-assisted laparoscopic prostatectomy over conventional open surgery include smaller incisions that may result in less postoperative pain, a shorter hospital stay, reduced blood loss, less need for blood transfusions, and a potentially faster recovery and return to normal activities. Robotic kidney surgery Kidneys can become damaged by many conditions, including diabetes, high blood pressure, infections, cardiovascular disease, cancer, cysts, stones and trauma. Damage to the kidneys can lead to severe health issues, including chronic swelling, electrolyte abnormalities, hypertension and the possible need for dialysis therapy to replace the function of the kidneys. In the past, most surgical treatments for kidney disorders required the removal of the entire kidney, called a radical nephrectomy— an open procedure that requires a very large, extremely painful incision that raises the risk for hernias and large scars and necessitates a long recovery time. The advent of robotic surgery has changed the need for such large incisions to access the kidneys, while allowing the urologist to perform the same surgeries. The da Vinci ® Surgical System is used to perform robot-assisted laparoscopic surgery for patients with renal tumors, adrenal gland tumors and blockage of the ureters. Urologists can even perform partial nephrectomies—removing only the tumor and leaving the rest of the organ intact. This helps preserve kidney function. The ability to perform these myriad procedures without making a large incision and requiring a significantly longer hospital stay for pain management has been a revolution in urologic care for patients in the United States. Robotic colorectal surgery During a robotic colectomy, surgeons remove cancerous portions of the colon and rectum, as well as benign tumors and polyps. A robot-assisted approach provides surgeons with the tools to more easily connect the two ends of the colon after the cancer has been removed. The procedure can be completed with a few tiny incisions, rather than the one long incision used in traditional open colon surgery. Robotic surgery allows surgeons to perform complex rectal cancer surgery, which had been extremely challenging, in a minimally invasive manner. The robot provides improved visualization of the surgical site through 3-D magnification, enhanced dexterity for manipulation and dissection of tissue, and greater precision. The robotic procedure allows surgeons to finely dissect cancers of the rectum while possibly reducing nerve injury. A recent study has shown that surgeries using the robot are less likely to require conversion to an open procedure than colorectal procedures performed laparoscopically. Robotic hernia repair Surgery for abdominal wall hernias may be performed through an incision in the skin or using minimally invasive techniques. In robot-assisted hernia repair, the surgical outcomes are typically similar to open repairs, but some patients may find a benefit due to smaller skin incisions. Any decision to have a robot-assisted hernia repair will involve the doctor’s discussion with each patient to identify which repair technique would be best for that patient. Issues such as hernia size, anticipated activity level and hernia location will matter in the selection of the appropriate hernia repair technique. Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if robotic surgery is right for you. Michael Bolt, MD, general surgery “The da Vinci robot has very intuitive control and more range of motion than the human wrist.”