Robot-Assisted Surgery

Robot-Assisted Surgery at Mayo Clinic

The surgeon performs robotic surgery by remote control, viewing the operating field on a video monitor.

Mayo surgeons in several specialties use computer-assisted systems (robotic surgery) to perform delicate and complex minimally invasive (laparoscopic) surgeries. The increased precision of the robotic system extends the benefits of laparoscopic surgery to some procedures previously possible to perform only with open surgery.

The robotic system gives surgeons better vision, maneuverability and control than is possible with standard laparoscopy. Mayo surgeons have performed more than 2,000 robot-assisted surgeries.

"Robotic surgery is an upgraded form of minimally invasive surgery and is associated with major patient benefits. The robotic operation is more precise than conventional surgery and it allows a patient to return to normal activities much more quickly. We have also noted a reduced use of pain medications after robotic surgery, indicating less tissue trauma," says Javier Magrina, M.D., gynecologist and surgeon at Mayo Clinic in Arizona.

The robotic system used at Mayo (the da Vinci Surgical System) was approved by the U.S. Food and Drug Administration in 2000 for use in abdominal procedures, in 2001 for prostate removal, and in 2005 for gynecologic procedures.

How Robotic Surgery Works

The robotic system is somewhat like a large video game in the operating room. It consists of two interactive mechanical arms, a camera arm, a three-dimensional (3-D) image processing system and a remote control unit.

The surgeon sits at the remote control and views the operating field on the video monitor. As the surgeon manipulates the remote control unit, the motions are translated to the robotic arms at the operating table. Each robotic arm consists of multiple appendages connected by joints which can be moved in a manner similar to a human wrist. A second surgeon at the operating table exchanges surgical instruments on the robotic arms.

Differences from Standard Laparoscopic Surgery

In traditional laparoscopic surgery, surgeons must perform movements in mirror image — that is, to move the instrument one way, the surgeon must move his or her hand the opposite direction. The robotic system electronically corrects the surgeon's view so the procedure can be done with the same natural movements as in normal surgery.

Robotic surgery is performed with the surgeon seated, viewing the surgical area in three dimensions, with the capability to magnify the surgical area up to 12 times normal size.

The robotic appendages move more like the human wrist and are less limiting than standard laparoscopic tools. This allows the surgeon to better access hard-to-reach areas and to easily tie knots for suture placement. The appendages also correct for hand tremor, which allows greater precision in operating on tiny structures.

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