Robot-Assisted Laparoscopic Procedures
Procedure
Definition
A robot-assisted laparoscopic surgery is when a doctor guides small robotic arms through tiny cuts in the belly to do surgery. It allows for greater range of motion than regular surgery.
Close-up view of laparoscopic tools used to remove the gallbladder (green structure).
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Reasons for Procedure
This method is used when surgery needs to be precise. Examples of robot-assisted laparoscopic surgeries are:
- Adrenalectomy —removal of the 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—corrects a bulging of internal organs or tissues
- Pyloroplasty—widens the opening in the lower part of the stomach
- Nephrectomy —removal of a kidney
- Nissen fundoplication —treatment for severe heartburn
- Prostatectomy —removal of the prostate
- Hysterectomy —removal of the uterus
- Myomectomy —removal of fibroids, which are noncancerous tumors in the walls of the womb
The benefits of this type of surgery are:
- Less blood loss
- Lower risk of infection
- Less scarring
- Less trauma to the body
- Faster recovery
- Less time in the hospital
Possible Complications
Problems from robot-assisted surgeries are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excessive bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Damage to nearby organs or structures
- The need to switch to traditional surgery types, such as traditional laparoscopic or open surgery
Things that may raise the risk of problems are:
- Smoking
- Chronic diseases, such as diabetes or obesity
- Alcohol use disorder
What to Expect
Problems to Look Out For
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from a wound
- Belly swelling or pain
- Severe nausea or vomiting
- Lasting diarrhea or constipation
- Blood in the stool
- Pain or swelling in the feet, calves, or legs
- Cough, shortness of breath, or chest pain
- Being unable to eat or drink liquids
- Headache and lightheadedness
- New or unexpected symptoms
If you think you have an emergency, call for medical help right away.
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging tests
Anesthesia
The doctor may give:
- Local anesthesia—the area will be numbed
- General anesthesia —you will be asleep
Description of the Procedure
Several small cuts will be made. A needle may be used to inject gas into the belly. This will make it easier to see inside the body. A scope with a small camera on the end will be passed through one of the cuts. The camera will display the area on a video screen. Next, robotic arms holding tools will be inserted through the cuts.
While sitting nearby, the doctor will use lenses to look at a magnified 3-D image of the inside of the body. Another doctor will adjust the camera and tools. The robotic arms and tools will be guided by the surgeon. When the surgery is done, the tools will be removed. Stitches or staples will be used to close the cuts. Bandages will be used to cover them.
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How Long Will It Take?
About 1 to 2 hours. It depends on the type of surgery.
Will It Hurt?
It depends on the surgery, but pain and swelling are common in the first 2 weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is about two days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Care Center
Right after the procedure, the staff may give you pain medicine.
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your wounds covered
You can also lower your chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your wounds
At Home
Activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work. It will take a few weeks to heal.
American College of Surgeons
National Heart, Lung, and Blood Institute
CANADIAN RESOURCES:
Canadian Cardiovascular Society
Health Canada
American College of Surgeons
National Heart, Lung, and Blood Institute
CANADIAN RESOURCES:
Canadian Cardiovascular Society
Health Canada
References
- Laparoscopic/robotic surgery. UF Health website. Available at: https://urology.ufl.edu/patient-care/robotic-laparoscopic-urologic-surgery.
- Management of appendicitis in adolescents and adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-appendicitis-in-adolescents-and-adults.
- Robotic surgery center. The Robotic Surgery Center at NYU Langone Medical Center website. Available at: https://nyulangone.org/locations/robotic-surgery-center.
- Robotically assisted heart surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17438-robotically-assisted-heart-surgery.
Contributors
- James P. Cornell, MD
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