Laparoscopic Surgery / Robotic Surgery

In a laparoscopic or robotic procedure, surgeons use small incisions (1/4 to 1/2 inch) to enter the abdomen through trocars (narrow tube-like instruments). The laparoscope, which is connected to a tiny video camera, is inserted through the small incision, giving the surgeon a magnified view of the patient’s internal organs on a television screen. The entire operation is performed “inside” after the abdomen is expanded by inflating gas into it in order to create a working operative space. There is no need for a large incision.

The advantage of the laparoscopic/robotic approach is that it usually provides:

reduced postoperative pain
shorter hospital stay
a faster return to work
improved cosmetic result
quicker return of bowel function
quicker resumption of regular diet
faster return to normal activities of daily living

What is the difference between laparoscopic and robotic surgery?

In many ways the two techniques are similar. Both surgeries are performed through small incisions. They both inflate the abdomen with gas in order to create a working space to operate. Further, both techniques involve performing the operation on a video screen.

In laparoscopic surgery, the surgeons’ actual hands are grasping and moving the instruments themselves while he or she performs the operation literally right next to the patient. In robotic surgery, the instruments are docked or attached to robotic arms. The surgeon then sits at a console next to the patient’s bed. The surgeon uses small controls at the console to control the robotic instruments.

Instruments used during a laparoscopic/robotic gallbladder surgery. These are placed through the abdominal (belly) wall and enable the surgeon to operate through small incisions.

When very small instruments are used for surgery, the scars left after surgery are very difficult to see and cause very little pain.

Almost all surgery in the abdomen used to be and sometimes still is performed by the open or conventional technique. Open or conventional surgery involves making a large incision (6 – 15 inches) in the abdomen in order for the surgeon to place his hands directly into the abdomen or belly in order to perform surgery.

Recovery after abdominal surgery has much more to with the incision size and length than the actual surgical procedure performed. As an incision increases in length, generally a patient experiences more pain and less mobility. These two factors can lead to difficulty breathing, a longer hospital stay, and a longer time away from work.