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Robot-Assisted Laparoscopic Procedures

by Krisha McCoy, MS

Definition

Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Definition TOP

A doctor uses robotic arms to operate through small keyhole incisions in the abdomen.

The robotic arms are able to do surgical tasks with an increased range of motion. They also can filter out hand tremor. The special tools translate the doctor’s larger hand movements into smaller ones. This allows delicate work to occur in small spaces.

Laparoscopic Cholecystectomy

Close-up view of laparoscopic tools used to remove the gallbladder (green structure).

Reasons for Procedure TOP

Some laparoscopic surgeries that have been successful using robotic techniques include:

Adrenalectomy—removal of adrenal gland
Appendectomy—removal of the appendix
Bariatric surgery—surgery of the stomach to treat obesity
Cholecystectomy—removal of the gallbladder
Colectomy—removal of the colon
Hernia repair
Pyloroplasty
Nephrectomy—removal of a kidney
Nissen fundoplication—surgical reinforcement of the valve between the esophagus and stomach
Prostatectomy—removal of the prostate
Hysterectomy—removal of the uterus
Myomectomy—removal of fibroids, which are noncancerous tumors in the walls of the uterus

Compared to more traditional procedures, robotic-assisted laparoscopic surgery may result in:

Less scarring
Reduced recovery times
Less risk of infection
Less blood loss
Reduced trauma to the body
Shorter hospital stay
Faster recovery

Possible Complications TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Damage to neighboring organs or structures
Infection
Bleeding
Anesthesia-related problems
The need to switch to traditional surgical methods such as traditional laparoscopic or open surgery

Factors that may increase the risk of complications include:

Smoking
Pre-existing heart or lung condition
Obesity
Diabetes
Excessive alcohol intake
Previous abdominal or pelvic surgery
Use of certain medications

Be sure to discuss these risks with your doctor before the procedure.

What to Expect TOP

Prior to Procedure

Depending on the reason for your surgery, your doctor may do the following:

Physical exam
Blood tests
Urine tests
Electrocardiogram (EKG)
Intravenous pyelogram (IVP)
X-ray of kidneys, ureter, bladder (KUB)
Abdominal or pelvic ultrasound
CT scan

Leading up to the procedure:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
Take antibiotics if instructed.
Take a laxative and/or use an enema to clean out your intestines if instructed.
Follow a special diet if instructed.
Shower the night before using antibacterial soap if instructed.
Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.
Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

Depending on the type of procedure that you have, you may be given:

General anesthesia—blocks pain and keeps you asleep through the surgery
Local anesthesia—just the area that is being operated on is numbed; given as an injection and may also be given with a sedative

Description of the Procedure TOP

Several small incisions will be made. They are called keyhole incisions. Carbon dioxide gas will be passed into the abdomen to expand it. This will make it easier for the doctor to view the area.

A small camera will be passed through one of the incisions. This tool is called an endoscope. It lights, magnifies, and projects an image of the organs onto a video screen. The endoscope will be attached to one of the robotic arms. The other arms will hold tools that are able to grasp, cut, dissect, and suture. These may include:

Forceps
Scissors
Dissectors
Scalpels

Laparoscopic Tools

The doctor will sit at a console, looking at the images on the screen. The robotic arms and tools will be guided by movements of the surgeon. Another doctor will stay by you to adjust the tools as needed. In some cases, organs or tissue might need to be removed. When the procedure is done, the tools will be removed. The incisions will be closed with sutures or staples and a sterile dressing will be applied.

How Long Will It Take? TOP

About 1-2 hours, depending on the type of procedure

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications. You may also feel discomfort from the gas used during the procedure. This can last up to 3 days.

Average Hospital Stay TOP

This procedure is done in a hospital setting. The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if you have any problems.

Post-procedure Care TOP

When you return home, do the following to help ensure a smooth recovery:

Wash the incisions with mild soap and water.
Limit certain activities, such as driving and strenuous activity.
Participate in any physical therapy or rehabilitation.

Depending on the procedure, you should make a full recovery within a few weeks.

Call Your Doctor TOP

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
Abdominal swelling or pain
Severe nausea or vomiting
Persistent diarrhea or constipation
Blood in the stool
Pain and/or swelling in your feet, calves, or legs
Cough, shortness of breath, chest pain
Being unable to eat or drink liquids
Headache, feeling faint or lightheaded
Excessive vaginal bleeding after a gynecologic procedure
Persistent or foul smelling vaginal discharge after a gynecologic procedure
New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American College of Surgeons
https://www.facs.org/education

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Health Canada
http://www.hc-sc.gc.ca

References:

The da Vinci surgical system. University of Southern California, Cardiothoracic Surgery website. Available at:
...(Click grey area to select URL)
Accessed February 19, 2016.

Robotic surgery. Brown University website. Available at:
...(Click grey area to select URL)
Accessed February 19, 2016.

Ruurda JP, van Vroonhoven ThJMV, et al.. Robot-assisted surgical systems: a new era in laparoscopic surgery. Ann R Coll Surg Engl. 2002;84:223-226.

What is robotic surgery? The Robotic Surgery Center at NYU Langone Medical Center website. Available at:
...(Click grey area to select URL)
Accessed February 19, 2016.

6/3/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Last reviewed March 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 5/29/2014

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