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Advantages of Robotic Surgery in Gynaecology: A Minimally Invasive Revolution

By Dr. Neena Singh Kumar in Obstetrics And Gynaecology

Jan 03 , 2024 | 3 min read

Gone are the days when you would receive a big, huge incision for your abdominal surgeries. Laparoscopic surgeries became common a decade earlier, and in today's date, robotic surgery is the most advanced minimally invasive surgery with tiny incisions instead of one large opening and is called minimally invasive surgery.

Robotic surgery is not done by a robot. The surgery is done by a surgeon using a robotic surgical system called Da Vinci. The Da Vinci system replicates the surgeon's movements in real-time. It cannot be programmed, nor can it make decisions on its own to move in any way or perform any surgical manoeuvre without the surgeon's control.

Robotic surgery is superior in technology compared to laparoscopic and endoscopic procedures.

Robotic surgery utilises the most advanced technology, allowing surgeons to perform complex surgical procedures that may not be feasible through laparoscopic or endoscopic procedures.

Robotic surgery has 3D vision, up to ten times better magnification and tremor filtration mechanisms.

Robotic surgery has several advantages over conventional surgery. There are benefits for the surgeon as well as the patients. Surgeons can perform complex procedures precisely due to better visualisation and access. The patients have a shorter hospital stay, lesser blood loss and faster recovery.

The robotic hand goes through the fingertip incisions (4 in number). The robotic arms support the robotic hand instruments like a tissue-holding grasper, scissors or bipolar grasper to cauterise the tissue. Robotic instruments are 8mm instruments which go through the fingertip incisions.

The surgeon does the surgery by looking at pictures on the computer screen. The surgeon sits on the console, which has a 3D monitor on which the surgeon sees and operates. The assistants have a separate monitor by the side of the operating table for them to see.

The tremor in the surgeon's hands does not affect the surgery; there is less blood loss compared to conventional surgeries because of the magnification and 3D image. The vessels are clearly visible, and you can coagulate them well in time. For bigger vessels, hemlocks are used. The operating time is less, and patients recover faster.

Scope of Robotic Surgery in Gynaecology

The Da Vinci surgical system can perform surgical procedures like hysterectomy, myomectomy, tumour removal, tubal block correction, prolapse correction and many more.

The uterus can be delineated with great ease, the ureters can be easily identified, and the hysterectomy operation becomes easier.

Myomas are tumours arising from the muscle of the uterus. Myomectomy refers to the surgical removal of these myomas, also known as fibroids, with minimal blood loss. The uterus remains preserved in this surgery.

Not only is the removal easy, but suturing is brilliant. One can do multiple-layer suturing for better haemostasis and better strength of the wound, hence enhancing fertility.

The surgically removed tissues are morcellated using robotic blades or power morcellation.

Robotic laparoscopic surgery is particularly beneficial for cancer patients wherein the removal of tumour tissues and lymph nodes becomes easier and complete. Robotic radical hysterectomy is a gold standard in gynaecologic oncology surgery and is widely accepted all over the world.

No abdominal drains are required in the postoperative period because of precise lymph node dissection. Early mobilisation of the patients helps early recovery.

Endometriosis is called a surgeon's nightmare because of the infiltrative nature of the disease and involvement of ureters, intestines and bladder. With the robot, it becomes so easy to operate that it is almost unbelievable. You have to see it to believe it.

Patients who have undergone a permanent sterilisation procedure like clipping of tubes are recanalised (tubal recanalisation) with great ease because of excellent suturing as a result of the dexterity of the robotic wrist.