Robotic Surgery in Oncology
- PDF / 142,185 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 44 Downloads / 238 Views
EDITORIAL NOTES
Robotic Surgery in Oncology M. Vijayakumar 1 & Rohan Shetty 1 Received: 22 September 2020 / Revised: 22 September 2020 / Accepted: 13 October 2020 # Indian Association of Surgical Oncology 2020
Robotic surgery is a novel technology in minimally invasive surgery which is becoming more popular among surgeons and patients. It helps the surgeons in operating inaccessible areas of human body with ease, in comparison to traditional open surgical techniques and laparoscopy. Patients are being benefitted by minimal scar, reduced blood loss, early recovery, minimum wound-related complications, and reduced hospital stay [1]. Robotic surgery got FDA approval in the year 2000. Initially, it was used in prostatectomy, hysterectomy, general surgical procedures, and minimally invasive cardiac valve repairs. Slowly the use of robotics was approved for surgeries of cancers involving inaccessible anatomical locations. This has led to the use of robotics in cancer surgeries all over the world in the last decade. Presently, cancer affecting prostate, bladder, kidney, rectum, endometrium, cervix, esophagus, mediastinal tumor, small wedge excision, metastatectomy, and lobectomy of lungs is being done. Initial success with respect to feasibility prompted the use of robotics in hepatobiliary, gastric, pharyngeal, and base of tongue cancers [2].
Pros and Cons The advantage of robotic surgery is three-dimensional (3D) vision with magnification and stable operating field which aid the surgeon to visualize complex anatomical area and dissect carefully to minimize injury to critical structures to improve functional outcomes. Also enhanced dexterity and endo-wrist movement make dissection and lymphadenectomy better. Scaling of motion and improved ergonomics make prolonged procedures safe with improved accuracy. Because of these reasons, the patient will have better post-op recovery, * Rohan Shetty [email protected] 1
Department of Surgical Oncology, Yen- Onco Center, Yenepoya (Deemed to be University), Mangalore, India
improved functional outcomes without compromising the oncological principles. However, there are some disadvantages in robotic surgery, such as anesthetic challenges because of the extreme positions, lack of haptic feedback which may result in cutting through the tumor, increased duration of the surgery, and the increased cost incurred [3].
Evidence Unlike the use of robotics in benign conditions, the use in cancer surgery is different. It poses different questions like whether the early advantages have compromised long-term benefits and also whether the surgery cost has become a burden on patient, compromising the adjuvant treatment. Both these defeat the very purpose of treatment in cancer. As far as evidence is concerned, there are systematic reviews and meta-analyses regarding the feasibility, oncological safety, learning curve, and functional outcomes. Presently all the studies have shown comparable short-term outcome, less conversion rate, and marginal benefit of robotic surgery in carcinoma r
Data Loading...
