Open Versus Laparoscopic vs Robotic Surgery
With ever-changing and improving techniques and technologies in the surgical field, even the most basic of surgeries today are performed very different from how they were performed just a few decades ago. With these improvements have come huge gains in patient safety. Further, the procedures we perform have never been more effective. To understand the amazing advances in modern surgery one should know the differences in technique and how they apply to today’s surgical landscape.
Traditional Open Surgery
The traditional open technique is what most people think of when they hear the word “surgery.” The open technique calls for a single large incision, the size of which depends on the procedure being performed. The surgeon directly visualizes the surgical field and uses his/her hands and short Instruments to perform the procedure directly inside the abdomen. Today, advances in visualization and medical device technology have made open surgery a less popular, but still relevant option in certain cases. For example, when performing an abdominal procedure laparoscopically, it sometimes needs to be converted to an open procedure for patient safety or if there is significant scar tissue in the surgical field. Further, very complex surgeries may call for an open approach.
The Advent of Laparoscopy
Laparoscopy, or minimally invasive surgery, became a sensation in surgical technique just a few decades ago. With improvements in higher definition camera technology, a laparoscope – simply a small telescope with a camera at the end of it – redefined minimally invasive surgical treatment. Over the past several decades, medical devices and techniques have been honed to make laparoscopic surgery the standard of care for almost every general surgical procedure in the abdomen. The main advantage of laparoscopy over open surgery revolves around the need for only three or four small incisions in the abdomen versus the large single incision of open surgery. This means that most patients will experience less pain, a quicker return to work and normal activity, a shorter hospital stay – many procedures are now performed on an outpatient basis – and a shorter overall recovery.
Understanding the few shortfalls of laparoscopy, robotic assistance was developed to overcome them and improve upon traditional laparoscopy. The surgeon controls every movement of the robotic arms while comfortably seated in a control station next to the operating table. The advanced, three-dimensional camera used by the robotic system offers an immersive experience for incredible visualization within the abdomen. Further, each of the robotic arms are “wristed” allowing for 360° movements. Amazingly, this offers greater dexterity than even the human wrist. Being that the surgeon is seated, the fatigue associated with laparoscopic and open surgery is significantly reduced, giving both patient and surgeon a better experience. The result is that may complex procedures that were not suited to traditional laparoscopy – and would have to be performed in an open manner – can now be performed robotically and minimally invasively. Of course, not every case is appropriate for robotic surgery. For some procedures, like a
As with any major procedure, surgeon experience is paramount to the safety of the patient and long-term success of the procedure. Whether it is open, laparoscopic or robotic surgery, patients need to focus on choosing the right provider for their case.