The latest frontier in the surgical field is robotic surgery: it has the same characteristics as classical laparoscopy but the surgeon, instead of manipulating the instruments with his own hands, does so with the help of a robot, which he controls through a console located outside the operating field: this allows the surgeon to work seated in a comfortable position. The three-dimensional projection of images partially overcomes the lack of depth perception. The surgeon is in control of the camera, which is mounted on a stable platform that prevents imprecise movement. In this way, surgical precision is significantly increased: tremor is filtered to allow precise positioning of the instruments, with greater agility in the execution of sutures and biliary and enteric anastomoses. The surgeon's movements are scaled to allow very fine small movements.
Advantages
Being a minimally invasive surgical procedure, robotics allows more advantageous results than the classic approach (classic, laparotomic, open surgery):
- faster recovery : most patients leave the hospital a few days after surgery (4-7 days); faster recovery allows cancer patients who need chemotherapy after surgery to start treatment sooner
- Reduced blood loss: With this approach, blood transfusions are rarely needed.
- less postoperative pain
- surgical site infection because the procedure uses small incisions (about 1% infection rate)
- Reduced risk of incisional hernia: Incisional hernia is due to collapse of the abdominal wall at the site of the surgical wound. The best way to prevent an incisional hernia from forming is to avoid making a large open incision.
- better aesthetic results : the intervention consists of small incisions, which heal completely in a short time with minimal scarring.
Indications
A minimally invasive approach to liver surgery is ideal for most patients. However, the indications for an intervention with a robotic approach should be evaluated based on the characteristics of the patient and the type of tumor.