Question

Single port robotic surgery.

Hint:

Single port robotic surgery provides the benefits of minimally invasive surgery with improved precision and cosmesis, but requires specialized instruments and expertise to overcome the challenges of working through one small incision.

Answer 1

Single port robotic surgery (SPRS) is a minimally invasive surgical technique that involves the use of a single incision, typically located in the abdomen, through which all the necessary robotic instruments and the camera are inserted. This technique provides surgeons with enhanced precision and control, minimizing scarring and reducing recovery times.
Step 1: Technique:
In SPRS, a small incision is made, usually around 2-4 cm, through which the robotic instruments are introduced. The robotic system, such as the da Vinci Surgical System, allows the surgeon to control the instruments via a console, offering a three-dimensional view of the surgical site. The single port setup requires special instruments that can be inserted and articulated through one point of entry. These instruments allow the surgeon to perform complex surgeries with precision and flexibility, despite the limited space.
Step 2: Advantages of SPRS:
- Minimally Invasive: SPRS involves a smaller incision compared to traditional multi-port laparoscopy, which leads to less pain, reduced scarring, and a faster recovery time for the patient.
- Improved Cosmesis: Because only one small incision is used, patients experience improved cosmetic outcomes with minimal scarring.
- Enhanced Precision: The robotic system provides high-definition, 3D views and precise control over surgical instruments, improving the surgeon’s ability to perform delicate and complex procedures.
- Reduced Hospital Stay: Patients undergoing SPRS typically have a shorter hospital stay compared to traditional open surgery, allowing for faster recovery and a quicker return to normal activities.
Step 3: Indications for SPRS:
- Colorectal Surgery: SPRS is commonly used for colorectal resections, including sigmoid colectomy, right hemicolectomy, and rectal surgeries.
- Cholecystectomy: Robotic-assisted single port cholecystectomy is an effective approach for gallbladder removal.
- Obesity Surgery: SPRS can be used for bariatric surgeries, such as gastric sleeve resection and gastric bypass.
Step 4: Limitations and Challenges:
- Limited Space: Working through a single port limits the space available for the surgeon to manipulate instruments, which may be challenging in more complex cases.
- Technical Difficulties: The use of specialized robotic instruments may lead to difficulty in instrument exchange, and there may be a learning curve for surgeons transitioning to single port techniques.