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which functions in the technical 'slave' fashion, doing only what the surgeon
performs with the console," says Andrew E. Bourne, MD, a urologist with
Siouxland Urology Associates and chairman for robotic surgery at Mercy
Medical Center in Sioux City, Iowa.
Robotic procedures start in a typical laparoscopic fashion to gain access to
the surgical area, says Dr. Bourne. The robot is then docked to the ports that are
placed during access, and the surgeon then moves to a console that's not part of
the sterile field, but kept close by. While the surgeon performs the procedure
using the console, a bedside surgical assistant helps with changing instruments,
suturing and retraction. Once the procedure is done, the robot is undocked and
the patient is closed as they would be during typical laparoscopy.
Originally designed for heart surgery, the robot can now be used for nearly any
procedure done with a laparoscope. Surgeons have found that it's best suited for
cases in hard-to-reach areas, especially around the pelvis, says Dr. Bourne. "It's
more helpful to facilitate surgeries in tight spaces, where it's difficult to suture or
get to the surgical site," he says.
While the robot features 3DHD visualization, doctors say its appeal is more than
just improved imaging. The robot's ergonomic design lets surgeons remain seated
at the console during procedures, and its wristed instruments bend and rotate
beyond what the human hand is capable of to allow for greater access. The sys-
tem also eliminates the possibility of hand tremors that might jeopardize case out-
comes. Jay Redan, MD, FACS, president of the Society of Laparoendoscopic
Surgeons and medical director of minimally invasive general surgery at Florida
Hospital-Celebration Health in Kissimmee, points out that 2 consoles can be wired
together, letting 2 surgeons work together on an operation.
A changing technology
Those core features draw surgeons to the robot, but new advances are opening
up even more possibilities. The robot's instruments are becoming smaller, the
