Robotic surgery may sound a little too high-tech for comfort, but rest assured, the
accurate term is robotic-assisted surgery.
A surgeon performs your procedure using very high-tech equipment. Originally designed for use on
battlefields, today the “robot” has become the latest technology at hospitals
There are 2 basic ways to do surgery. In open surgery, the surgeon makes a large
incision to look and work directly inside the body. In laparoscopy (minimally
invasive surgery), the surgeon makes 1 or more small incisions and inserts a light and a
camera into the openings.
Many types of open surgical procedures can now be done laparoscopically. Advantages include
smaller incisions, less blood loss (and less need for transfusions), less pain while recovering, and
shorter hospital stays. Disadvantages include rigid tools, a need for the surgeon to operate tools
in a tight space, and the surgeon’s view is on a video screen, which can be confusing.
Robotic surgery is a newer kind of laparoscopic surgery. The surgeon makes small incisions, but
the instruments work through a robotic device. The surgeon sits at a console and operates the
robot’s arms, which in turn move tiny tools inside the patient’s body.
There are many advantages to robotic surgery. The surgeon can view a high-quality, 3-D image and
can move his or her hands and wrists more naturally. The robot can reduce tremors in the
surgeon’s movements and is helpful for surgery in tight spaces in the body. Robotic surgery is
particularly helpful for certain types of procedures in which access is difficult.
Disadvantages include a significant learning curve for surgeons to become fully expert. Some
surgeons miss the “feel” of direct contact with the patient’s organs. And robotic
surgery takes longer, regardless of the surgeon’s expertise.
There are few well-designed studies of robotic surgery compared with traditional laparoscopic
surgery. A recent study found that there was no advantage to patients for robotic surgery, and it
costs a great deal more than traditional laparoscopic surgery.
Robots can cost $1.5 million to $1.75 million each plus the expense of annual maintenance and the
necessary disposable instruments. There is no manufacturing competition to lower costs; in the
United States, only 1 system has FDA approval.
Without much better outcomes, it is difficult for hospitals to justify the purchase price. In the
end, patients will pay for the overall increased costs in the form of higher insurance premiums.
National Library of Medicinehttp://www.nlm.nih.gov/medlineplus/ency/article/007339.htm
To find this and previous JAMA Patient Pages, go to the Patient Page link on
JAMA’s website at jama.com. Many are published in English and Spanish.
Conflict of Interest Disclosures: The author has
completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none
Sources: National Library of Medicine. Wright J, et al. JAMA.
Sugerman DT. Robotic Surgery. JAMA. 2013;310(10):1086. doi:10.1001/jama.2013.75621