Since 1990, laparoscopic and more recently robotic surgery has become main stream as minimally invasive surgical alternatives for many urologic conditions including both benign and cancerous conditions.
In most cases, laparoscopic and robotic surgery has resulted in:
- Less pain and scarring
- Less blood loss
- Fewer blood transfusions
- Less risk of infections
- Shorter hospital stay
- Faster return to normal activities
Laparoscopic surgery allows a surgeon to perform complex procedures within the abdomen without having to place his hands directly into the body cavity. This is achieved by using miniaturized instruments placed through portals, called trocars, inserted through keyhole size incisions made in the abdomen. The abdominal cavity is inflated with carbon dioxide gas to provide a working space for the surgeon to operate in. Visualization of the internal anatomy is provided by a high definition, digital camera attached to a telescope lens inserted through one of the trocar sites. As the incision size tends to be smaller than for open surgery, postoperative pain is reduced in addition to blood loss and transfusions.
More recently, robotic surgery, introduced into the field of urology in 2000 has gradually supplanted many of the laparoscopic procedures due to advancements in visualization, ergonomics and instrumentation. Robotic surgery using the da Vinci™ Surgical Robotic System provides distinct advantages over conventional laparoscopic surgery.
- First, improved optical technology provides surgeons with not only a high definition, 10-12 X magnified view but also more specifically a three-dimensional depth perception of the internal anatomy as compared to the two-dimensional view offered by laparoscopic surgery.
- Second, instead of the rigid instruments used during laparoscopic surgery, advancements in multi-jointed robotic instruments allow the surgeon to operate with the same ergonomic freedom as using his hands and wrists thus providing greater range of motion of instrumentation.
- Third, motion scaling technology allows for reduction in tremor and highly precise surgical dissection during robotic surgery.