Doctors Bust Your Most Common Robotic Surgery Myths
When patients hear they should have robotic surgery some experience a fear of machines, others mistakenly think nothing can go wrong. “All moves of robotic instruments are following the hand of the surgeon controlling the joystick, “Although the robot is an excellent tool, it comes down to the surgeon’s experience to conduct a successful surgery.
Another myth is that the robot will do surgery and nothing can go wrong.”
In reality, robotic surgery is just another laparoscopic tool that allows for minimally invasive surgery, which is especially useful in the deep pelvis, given how small an area it is
Myth: A robot performs the surgery. The surgeon just feeds in some data and then disappears from the scene.
Fact: Robot’ implies some degree of autonomy in decision making to achieve certain pre-programed tasks. The surgical robot System’ is completely dependent on the surgeon for every movement and action. While the surgeon sits on a console and manipulates the hand and foot controls, the robotic system translates this into the movements of fine instruments inside the patient’s body. This is very similar to driving a car or flying an airplane – only there is no autopilot mode here. If the surgeon stops, the robot stops too.
Myth: Robotic surgery is an expensive gimmick with no real advantages.
Fact: There is no doubt that robotic surgery is more expensive than conventional laparoscopic or open surgery. There is an initial investment and a recurring cost involved in purchasing and maintaining this equipment. It usually adds about 25 – 30% to the total hospital bill for any surgical procedure. However, some of the additional cost is offset by advantages such as a shorter hospital stay, early recovery and – if certain latest research studies are to be believed – a decrease in complication rates associated with robotic surgery.
Myth: Robotic surgery does not allow the surgeon to ‘feel’ the internal organs and therefore clearance of cancer is not as good.
Fact: It is true that the present generation of robotic systems do not allow for a sense of feel for hardness or softness of an object. However, it is more than overcome by the excellent high definition 3D vision, magnified 10 to 12 times by the robotic camera. This allows the surgeon to develop ‘visual cues’ to sense the texture and hardness of the organs inside the body, which allows for a smooth and meticulous operation. Although, long-term outcomes are still not available for most procedures, early results have consistently pointed towards an equivalent cancer control with robotic surgery vis a vis the conventional ‘open’ operation. There are also those who suggest that this better visualization may actually improve cancer clearance by making it easier to discern between normal and abnormal parts of the organ – however, this is something that is yet to be proven by properly designed research studies.
Myth: Robotic surgery is easy. Anybody can do it!
Fact: Robotic surgery is not easy – it just looks as if it is. Like any other type of surgery, it needs a solid foundation of knowledge and skills to achieve the best results. It is not the machine, but the man behind the machine that matters the most. Robotic surgery offers a completely different interface as compared to conventional open or laparoscopic surgery and it takes specialized experience and training in this particular technology to master its fine nuances. The ‘learning curve’ or the number of operations that need to be performed by a surgeon to become proficient is widely estimated to be between 50 and 350 cases for robotic surgery.
Myth: Laparoscopic surgery cannot be performed on very old patients and young children.
Fact: Age is no bar. Successful operations have been done on patients as young as 6 months and as old as 90 years.
Myth: Open surgery is better because surgeon can see better with his own eyes
Fact: Laparoscopy provides upto 20 times magnification. Hence the surgeon can identify structures much more clearly for a precise operation without causing bleeding.
Myth: Does the robot ever malfunction? Is a malfunction dangerous? Can the machine go haywire on me?
Fact: Despite routine maintenance of the robot, and routine checks of the robot immediately prior to surgery, on rare occasion, malfunctions occur during surgery and the robot cannot be used. There are multiple safety features, however, that prevent any malfunction from causing a direct injury: the instruments either lock in place, in which case they need to be unlocked; or the instruments “float” gently, but do not drive forcefully in any direction.