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Frequently Asked Questions about Robotic and Minimally Invasive Surgery

Please click one of the question topics below to be taken to that section's FAQs.

General Questions

Robotic Gynecologic Surgery

Robotic Prostate Surgery

 


General Questions

Q.  What is minimally invasive surgery?
Minimally invasive surgery is performed through small incisions, rather than the large openings required in “open surgery”.  Minimally invasive surgery has become standard-of-care for many surgical procedures because in many patients it enables shorter recovery times with less blood loss and smaller scars. 

Q.  What is laparoscopic surgery?
Laparoscopic surgery is minimally invasive surgery conducted with the aid of a tiny video camera and specially-designed miniature instruments.  The camera transmits images to High-Definition video monitors that provide surgeons with amazing visual acuity that enables precise manipulation of the surgical instruments.

Q.  What is robotic surgery with the da Vinci Surgical System?
Robot-assisted (or robotic) minimally invasive surgery is conducted using the latest advancements in computer technology, instrumentation, and 3-D High-Definition imaging.  The da Vinci Surgical Robot helps enhance the surgeon’s skill by providing a greater range of motion, dexterity and precision.

Q.  Does the robot perform the operation? 
No. The robot is completely under the control of the surgeon. It cannot be programmed, nor can it make any movements on its own.  So, while the term "robotic surgery" is often used, a robot is not performing the surgery.  “Robot-assisted surgery” is a more accurate term.

Q.  What are the benefits of using the da Vinci Surgical System compared to traditional surgery?
Complex conditions like cancers of the prostate, cervix, uterus, lung, colon/rectum, as well as benign conditions such as fibroid tumors can now be treated minimally invasively through da Vinci Surgery.  There are many potential benefits for a patient when comparing da Vinci Surgery to traditional open surgery, including:

  • Shorter hospital stay1,2,3,4
  • Less blood loss2,3,4,5
  • Less pain1,6,7,8
  • Faster recovery1,2,9,10
  • Smaller incisions for minimal scarring11

Speak with your doctor to see if this approach is right for you.

Q.  What should I look for when selecting a robotic surgery program?
Experience in conducting minimally invasive and robot-assisted surgery is important when selecting your surgeon.  Northern Westchester Hospital's highly-credentialed surgical specialists routinely perform minimally invasive surgeries to treat a wide range of conditions. 

Robot assisted surgery requires a great deal of training.  Northern Westchester Hospital is the only regional hospital with a training simulator that surgeons use to refine their skills and master various robotic techniques. This system is similar to a flight simulator that pilots use when training to fly jet airplanes.  The robotic surgery simulator enables surgeons to perfect their skills and meet the stringent requirements that are necessary for performing highly-precise robot-assisted surgery.

Equally important is finding a hospital that has a comprehensive minimally invasive and robotic surgery program, such as Northern Westchester Hospital’s Institute for Robotic and Minimally Invasive Surgery.  The hospital should have standards that include certification in robot-assisted surgery and a surgical team that is deeply experienced in conducting robot-assisted procedures.  This helps to ensure that you experience safe, high quality surgical outcomes.

Northern Westchester Hospital has been ranked among the best regional hospitals in New York for Urology and Gynecology by US News & World Report.


Robotic Gynecologic Surgery

Q.  Is Robot-Assisted surgery appropriate for every case?
Although the robot is an effective instrument, it is not appropriate for every case. Certain medical conditions, the size of the fibroid tumors, contraindications to general anesthesia and the shape of the patient’s body are all factors that must be considered.

Q.  Is the robot actually conducting the surgery?
No. That is a common misperception. The robot is simply one more instrument that the surgeon uses to conduct the surgery. The robot enables the surgeon to perform the procedure with a greater level of finesse, which helps to deliver successful patient outcomes.

Q.  How does the robotic surgical system work?
The robotic system consists of interactive mechanical arms, a camera arm, a three-dimensional (3D) image processing system and a remote control unit. The unit is located in the same operating room as the patient. As the surgeon manipulates the remote control unit, the motions of the surgeon are translated to the robotic arms. The “hand” of the robot holds interchangeable surgical instruments that can be moved in a manner similar to a human wrist.

Q.  How soon after surgery can I go home?
In many cases, patients who have undergone minimally invasive hysterectomies are able to going home the day of or the day after surgery. In many cases they are able to return to work within one to two weeks.

Q.  Is the recovery time shorter?
In many cases the recovery time after robot-assisted surgery is shorter, but patients can be misled by the relative ease of the surgery. Although patients generally experience little pain and typically have only a small bandage to show from the procedure, they remember that minimally invasive robotic-assisted surgery is still major surgery. Therefore, patients need to allow themselves the necessary time to recover and heal properly.

Q.  How common is a hysterectomy procedure?
Hysterectomy is a common treatment for many gynecologic conditions, with 600,000 hysterectomies performed in the U.S. each year. One in three women will have a hysterectomy before the age of 60.

Q.  Is robotic hysterectomy surgery an option for overweight patients?
Overweight women may be eligible, as new instruments are longer and held in place by the arms of the patient cart. Studies have shown no significant difference in the outcome of overweight patients compared to thinner women.


Robotic Prostate Surgery

Q. What are some of the available surgical treatments for prostate cancer?
There are three surgical options to remove the entire prostate gland. These options are for patients with early diagnosed organ-confined prostate cancer.

Robot-assisted Radical Prostatectomy
Laparoscopic Radical Prostatectomy
Traditional Open Radical Prostatectomy

Q. What is robot-assisted prostatectomy?
Robot-assisted prostatectomy is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology.  The da Vinci Robot provides the surgeon with a 3-D HD view of the surgical field.  This is a vast improvement over the 2-D view of laparoscopic surgery.   This procedure is also called “da Vinci robotic prostatectomy.”

Q. How long do I stay in the hospital?
Most patients leave the hospital the day after surgery.  This is of course determined on an individual basis by the healthcare team for each patient.  By the second night, the majority of our patients are comfortable enough to go home.

Q. Are the nerves responsible for sexual function being spared during this procedure?
Every effort is made to spare the nerves. One of the main advantages of this procedure is the fact that the nerves and vessels are all magnified and it is much easier to save them. Return of potency could take up to six months and, in some individual cases, medication has helped the patients.  

REFERENCES
1Park JS, Choi GS, Lim KH, Jang YS, Jun SH. S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc. 2011 Jan;25(1):240-8. Epub 2010 Jun 15.
2Poston RS, Tran R, Collins M, Reynolds M, Connerney I, Reicher B, Zimrin D, Griffith BP, Bartlett ST. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008 Oct;248(4):638-46.
3Health Information and Quality Authority (HIQA), reporting to the Minister of Health-Ireland. Health technology assessment of robot-assisted surgery in selected surgical procedures, 21 September 2011.
4Landeen LB, , Bell MC, Hubert HB, Bennis LY, Knutsen-Larson SS, Seshadri-Kreaden U. Clinical and cost comparisons for hysterectomy via abdominal, standard laparoscopic, vaginal and robot-assisted approaches. S D Med. 2011 Jun;64(6):197-9, 201, 203 passim
5deSouza AL, Prasad LM, Ricci J, Park JJ, Marecik SJ, Zimmern A, Blumetti J, Abcarian H. A comparison of open and robotic total mesorectal excision for rectal adenocarcinoma. Dis Colon Rectum. 2011 Mar;54(3):275-82
6Cerfolio RJ, Bryant AS, Skylizard L, Minnich DJ. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg. 2011 Oct;142(4):740-6. Epub 2011 Aug 15.
7Lowe MP, Hoekstra AV, Jairam-Thodla A, Singh DK, Buttin BM, Lurain JR and Schink JC. A comparison of robot-assisted and traditional radical hysterectomy for early-stage cervical cancer. Journal of Robotic Surgery 2009:1-5.
8Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology. 2002 Nov;60(5):864-8.
9Bell MC, Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, and Hunt S. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy, and robotic techniques. Gynecologic Oncology III 2008:407-411.
10Miller J, Smith A, Kouba E, Wallen E, Pruthi RS. Prospective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy. J Urol. 2007 Sep;178(3 Pt 1):854-8; discussion 859. Epub 2007 Jul 16.
11Data on file with Intuitive Surgical, Inc.

 


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