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Robotic Surgery Q&A with Dr. Lublin

What is robotic surgery?

Robotic surgery uses the same principles as traditional laparoscopic surgery, however your surgeon interfaces with a robotic system to guide the minimally invasive devices within the abdomen.

Does the robot perform any of the procedure itself?

No, I am always in control of the robot. Only the inputs that I give tactilely are then translated to the patient. Think of the robot as an extension of my arms, wrists and hands.

Is the robot better than traditional laparoscopic surgery?

Whenever a new patient comes into our office, we perform a complete workup that includes medical history, a physical exam, and diagnostic testing. Based on the results of these evaluations, we decide the best course of action from a surgical technique perspective. Laparoscopic surgery is usually more beneficial than open surgery. Robotic surgery is typically necessary for more complex cases that would otherwise have to be performed an open manner. Some surgeries simply do not need to incur the cost of the robotic procedure as outcomes and safety are the same as traditional laparoscopy.

Do you perform the procedure from far away?

No, when I perform a robotic procedure, I am just to the side of the operating table. Being present allows me to convert the procedure to a straight laparoscopic procedure or an open one, in case there is an unexpected development.

What are the benefits for patients?

The main benefit of robotic surgery is the ability to perform complex cases that could not be done in a traditional laparoscopic manner. Now, rather than resorting to open surgery, many can be done with the assistance of the robot.

What are the benefits to the doctor?

The benefits for us are significant. The robotic console allows us to look directly into a 3-D image of the surgical field which improves visualization over the 2-D computer monitor usually placed above the operating table. We are also in a sitting position which reduces fatigue over the course of the day.  Lastly, the robotic arms are hinged in such a way that the range of motion is even greater than that of the human wrist. The result is the ability to perform precise movements without needing open surgery.

Are there any downsides to using the robot?

Because of the highly advanced and technical nature of the equipment used during robotic surgery, hospitals that do you have a robot are typically heavily booked. That means that not every case can be performed robotically. Robotics surgery also tends to take slightly longer than traditional laparoscopy. It is also somewhat more expensive.

What is the learning curve for a robotic surgeon?

As with anything, learning a new skill or technique takes time. The nature of the technology powering the robot is such that the learning curve is relatively short. Having performed robotic surgery for the past 5 years, it has become second nature and just as straightforward as traditional laparoscopy.

What procedures are typically performed with robotic assistance?

Many general surgical procedures can be performed with robotic assistance. Hernias, colon resections, gallbladders, and gastric sleeves and more can all be performed robotically. However, the benefit of performing these surgeries robotically vs. pure laparoscopically has not been clearly shown. Many times the decision is based on surgeon preference.

What is the future of robotic surgery?

While robotic surgery has revolutionized some surgical techniques, I see the robot as an amazing opportunity to offer highly skilled surgical services remotely – to areas that have poor or intermittent access to quality healthcare. Once a solid and reliable communication system can be developed, I can imagine it will be used on the battlefield as well as in developing countries with poor access to quality surgical care.

Are robots taking over the world?

Maybe, but it looks like we’re OK for now.

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