Most of us have seen old black and white videos of astronaut Neil Armstrong’s historic walk on the moon. While the rocket he and two other astronauts flew was the most intricate and sophisticated vehicle at that time, here’s a piece of trivia that is truly mind-blowing: The smartphone we all carry around today has more power and memory than the computer guidance system used to launch Americans into space in 1969. Technological advances are moving at warp speed in many industries, but especially in healthcare. For instance, surgeons are not only assisted in the operating room by other healthcare practitioners but some, like me, work alongside a robot. And, yes, I am commonly asked by many patients as well as colleagues: What, exactly, is the robot?
The robot we use in surgery is comprised of three components:
- A free-standing piece that has four robotic arms that are equipped with various medical instruments.
- A surgeon console where the surgeon sits and, using special hand controls, moves the arms to perform the surgery.
- A Vision Cart that relays video and mechanical inputs as well as controlling other aspects of the surgery.
As a surgeon, I can attest that there are many advantages to robot-assisted surgery. The one that benefits patients the most is that complex surgeries can be done without having to make large incisions. Instead, surgeons perform what is called laparoscopic surgery.
During laparoscopic surgery, the first thing a surgeon does is make several small incisions on the patient’s belly that are no larger than a finger’s width. One incision is used to inflate the abdomen allowing room for the insertion of a thin rod that has a camera and light attached, so we can see inside the body. Then using the robot’s arms, each equipped with a thin surgical instrument, the surgeon inserts the tool through each incision and performs the surgery by controlling the movement of the arms.
In my practice, I use the robot on nearly every hernia surgery as it allows me to fix large defects in the groin, belly button, and other sites without having to make a large incision. By being less invasive, most of my patients can go home the same day as the surgery. I also use the robot to do bariatric or weight loss surgery, where the platform allows careful dissection in patients who struggle with obesity.
Other advantages include improved visualization and flexibility of the robotic platform that enables me to perform more delicate and difficult surgeries. Equally as important, some studies show that patients undergoing robot-assisted surgery have less pain after surgery.
Now, it does take many years of training to become an expert in the use of robot-assisted surgery, but it’s worth it as there are undeniable benefits to patients and surgeons alike. If there is one setback with the technology, it is the cost. When compared to the more conventional laparoscopic approaches where no robot is used, this technology is expensive.
Nonetheless, these devices continue to gain popularity in operating rooms throughout the United States, and improvements in technique, training, and design are steadily decreasing costs. Assuming these trends continue, I am reminded of the identical concern and skepticism when laparoscopy first started several decades ago. While laparoscopy today is universally recognized as safe and effective—the gold-standard approach for many surgeries including appendix and gallbladder removal—in the 1990s and early 2000s, it was widely seen as unproven, too expensive, and potentially unsafe.
I believe that robotics in the 2020s is at a similar moment—the last decade has seen dramatic improvements in use, training, and cost reduction, and there is every indication they will continue. I advise all my patients to ask their surgeons about minimally invasive options for any procedure and to understand why and how a particular technique is being used. With patient and surgeon partnership, robot-assisted surgery could become the gold standard of the future.
About Dr. Peter Lundberg:
Dr. Peter Lundberg was raised in Massachusetts and attended Boston College followed by Loyola University-Chicago for medical school. He fell in love with New Orleans during his residency in general surgery at Tulane, after which he completed a bariatric and minimally invasive surgery fellowship at St. Luke’s University in Pennsylvania. Dr. Lundberg performs sleeve gastrectomy, gastric bypass, and revisional bariatric procedures with a personalized approach for every patient, using minimally invasive techniques to ensure a safe, satisfactory outcome with minimal pain and a rapid recovery. Dr. Lundberg is certified by the American Board of Surgery and has been extensively published in general and bariatric surgery literature. He also maintains leadership roles in both the state and national chapters of the American Society for Metabolic and Bariatric Surgery and is a tireless advocate for educating patients, providers, employers, and legislators on the benefits of weight loss surgery. His greatest passion, however, is establishing meaningful relationships with patients — to listen, understand, and honestly find the best way forward as a team.