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Robotic Surgery Complications

Robotic surgery has been making a lot of headway in recent years. There are now robotic systems capable of performing heart, gastrointestinal, gynecological, urological and orthopedic surgeries. As with any new medical technology, it is important to understand the benefits of robotic surgery, as well as the potential complications that might arise.

  1. History of Robotic Surgery

    • Robotic surgery was first performed in 1986, when a PUMA robotic arm was used to place a needle for a brain biopsy, while being guided by CT. Prostate surgery was first performed by a robot in 1988, when Imperial College London developed PROBOT. ROBODOC was developed in 1992, to precisely mill the femur to accept the femoral implant in total hip replacement surgery. The da Vinci Surgical System was first used in 1997, and it has been used for heart bypass, prostatectomy, fallopian tube reconstruction and kidney transplant.

    Benefits

    • Robotic surgery has allowed some surgeries to be performed with greater precision, and through smaller incisions. Robots can enable minimally invasive surgery, due to the reduced need of visual landmarks in order to adequately perform the surgery. This can lead to reduced risk of infection and lower blood loss. Robotic surgery can also increase the accuracy with which surgery is performed. This can reduce postoperative complications, such as the need for revision surgery, and it can also lead to shorter recovery times and a more successful surgery.

    Types of Complications

    • For any major surgery, there is a risk for a wide range of potential complications. Robotic surgery does not eliminate these risks. Additionally, certain other risks may be posed. Surgery times can be increased, due to the need to adjust the robot properly to the patient, leading to potentially increased risk of infection. Some systems require extra means of fastening the robot to the patient, which could lead to increased blood loss or infection. Robotic malfunction, while rare, can occur, and may require a system reboot, or the abandoning of the robotic portion of the surgery in favor of traditional techniques. Finally, local injuries may occur due to exposure to the robot, which might otherwise not occur using traditional tools and techniques.

    Risks

    • Typically, the risk of complications involved in robotic surgery is not significantly greater than that posed by traditional, open surgery. Surgical systems are not often approved for general use without demonstrating that they do not pose significantly more risk to a patient. Carefully reading over an informed consent agreement can give a patient a better understanding of the risks posed by a specific type of surgery and how those risks are mitigated by the robotic system.

    Future Outlook

    • Robotic surgery has been on a marked rise in recent years. The benefits so far seem to outweigh the costs. The ability to perform a surgery more precisely, while being less invasive, mitigates any potential complication, and as more research is done, the rates of complications will be lessened still. Currently, the most significant factor inhibiting the use of robots in surgery is their cost.

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