Nowadays, robots help us do a little bit of everything: Play music, vacuum, and in some cases—assist surgeons with performing operations.
On top of allowing physicians to apply minimally invasive techniques to a variety of different procedures, the use of robotic surgery means surgeons can operate on even the most complex of cases without compromising technical precision and flexibility.
“We’re seeing robotic technology on the rise for a number of reasons,” said Alexander L. Ayzengart, M.D., M.P.H, F.A.C.S, an assistant professor in the division of gastrointestinal surgery. “But at the end of the day, they can all be linked back to one thing—improvement in how we deliver patient care.”
Although surgical specialties utilizing robotic surgery run the gamut from thoracic surgery to urology, gastrointestinal (GI) surgery is uniquely suited to benefit from the innovation that robot-assisted procedures can provide, Ayzengart said.
In many GI surgeries, like colorectal procedures, the confined space of the pelvis makes certain movements and execution of surgical technique much harder. With the addition of a robot, however, surgeons can visualize the space they are operating in 3-D, and exert more control over their movements.
“We’re looking at a subtler, inherently safer surgical technique,” Ayzengart said.
Aside from its ability to reduce human errors that occur due to tremors, fatigue, and imprecision, one of the hallmarks of robotic surgery is its ability to approach even the most difficult cases, complicated by comorbidities or advanced illness, using minimally invasive procedures.
“The very small incisions associated with minimally invasive procedures, whether laparoscopic or robotic, are associated with lower postoperative pain, less narcotic use, quicker return of bowel function and even shorter hospital stays,” said Lindsey Goldstein, M.D. ., F.A.C.S, F.A.S.C.R.S and assistant professor in the division of generally surgery. “Not to mention the patient’s recovery, which is often smoother.”
Robotic technology can also extend to improvements in the quality of operation—like being able to confirm that blood supply to an organ is flowing correctly throughout the procedure, by using adjunctive techniques that are embedded into the robotic systems.
“We’re able to take on more complicated cases and tend to have a more functionally improved result,” Ayzengart said. “This holds true for stomach and esophageal cancers, as well as cancers of the pancreas, liver, and so on.”
In GI surgery, many operations are still performed using one large incision, Ayzengart said. When laparoscopy was introduced, the use of so-called “straight sticks” often constricted maneuverability during operations, making learning the skillset challenging.
By contrast, robotic surgery utilizes 360-degree wrist articulation, making it more natural to learn and perform more complicated operations, allowing trainees and practicing surgeons more precision and exposure to cases of varying difficulties—part of the reason UF Health has expanded its robotic program, which includes several Xi robotic platforms, one of the more advanced models, Goldstein said.
“Using robotic surgery expands upon our minimally invasive surgical options, meaning we can take on cases that we would not have been able to perform laparoscopically,” Goldstein said. “This is becoming technology marketed broadly in the community—so much so that we actually have patients requesting it.”