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Robotic surgery is safe and feasible for a wide variety of procedures.
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Robotic surgery is being increasingly used in complex abdominal procedures.
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The use of robotics potentially extends indications for several procedures beyond what is possible with conventional laparoscopy but will not fully replace laparoscopy.
Robotic Developments in Cancer Surgery
Section snippets
Key points
Conventional laparoscopy and robotic surgery
Over the past few decades there has been increased utilization of minimally invasive surgery. Currently, conventional laparoscopy is the standard approach of treatment for several procedures, including cholecystectomy and appendectomy.14, 15, 16 The benefits of minimally invasive surgery over open surgery include less blood loss, less postoperative pain, and quicker recovery from surgery and thus a shorter hospital stay.17, 18, 19
With the benefits of minimally invasive surgery being evident,
Technical advances of robotics in cancer surgery
With extending indications and the fact that more and more complex oncologic surgeries are performed robotically nowadays, the current robotic systems are better equipped than the first generation brought to the market 17 years ago, with many new tools aimed at optimizing oncologic surgery.
The articulating instruments and a 3D, magnified view allow the surgeon to perform precise dissection with optimal dexterity. In addition, the most advanced surgical robot currently available is designed to
Robotic outcomes in key complex abdominal cancer surgery
Several complex procedures in abdominal cancer surgery can specifically be identified, which, in theory, benefit the most from a robotic approach. For example, the optimized view and increased robotic dexterity are beneficial when constructing anastomoses in esophageal resection or in pancreatoduodenectomy or when performing extensive lymphadenectomy in a patient with gastric cancer. Moreover, the articulating robotic instruments allow for minimally invasive surgery in areas that are difficult
Future directions
Several surgical robots from other companies are expected to be launched in the upcoming years, including machines from companies such as Verb Surgical (Verb Surgical Inc, Mountain View, CA, USA), Ethicon and Google’s collaborative company, and Medtronic (Medtronic, Dublin, Ireland). These new entries into the robotic field are likely to bring down the costs associated with the robotic technology and push for further innovation.
Moreover, new machines might come with new interfaces, additional
Summary
Robotic surgery has experienced an extensive growth over the past 2 decades. Many studies in different fields of surgical oncology have displayed safety and feasibility of the robotic platform and comparable outcomes with conventional laparoscopy. In contrast to 20 years ago, complex procedures are performed using robotics nowadays and several technical tools, including Firefly technology and Tilepro multiscreen imaging, have become available to optimally facilitate oncologic surgery.
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Disclosure Statement: C.L.M.A. Nota, F.J. Smits, I.H.M. Borel Rinkes, I.Q. Molenaar, and J. Hagendoorn have declared no conflict of interest. Y. Fong is a scientific consultant to Medtronics Inc. Y. Woo is a scientific consultant to Johnson and Johnson Inc.
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Present address: Postbus 85500, 3508 GA, Utrecht, The Netherlands.
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Authors Carolijn L.M.A. Nota and Francina Jasmijn Smits have contributed equally to this work.