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Biochemical implications of robotic surgery: a new frontier in the operating room

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Abstract

Robotic surgery represents a milestone in surgical procedures, offering advantages such as less invasive methods, elimination of tremors, scaled motion, and 3D visualization. This in-depth analysis explores the complex biochemical effects of robotic methods. The use of pneumoperitoneum and steep Trendelenburg positioning can decrease pulmonary compliance and splanchnic perfusion while increasing hypercarbia. However, robotic surgery reduces surgical stress and inflammation by minimizing tissue trauma. This contributes to faster recovery but may limit immune function. Robotic procedures also limit ischemia–reperfusion injury and oxidative damage compared to open surgery. They also help preserve native antioxidant defenses and coagulation. In a clinical setting, robotic procedures reduce blood loss, pain, complications, and length of stay compared to traditional procedures. However, risks remain, including device failure, the need for conversion to open surgery and increased costs. On the oncology side, there is still debate about margins, recurrence, and long-term survival. The advent of advanced technologies, such as intraoperative biosensors, localized drug delivery systems, and the incorporation of artificial intelligence, may further improve the efficiency of robotic surgery. However, ethical dilemmas regarding patient consent, privacy, access, and regulation of this disruptive innovation need to be addressed. Overall, this review sheds light on the complex biochemical implications of robotic surgery and highlights areas that require additional mechanistic investigation. It presents a comprehensive approach to responsibly maximize the potential of robotic surgery to improve patient outcomes, integrating technical skill with careful consideration of physiological and ethical issues.

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Data availability

Data availability correspondence should be addressed to noorazarian_a@khoyums.ac.ir.

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  1. Leila Mokhtari and Fatemeh Hosseinzadeh contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran

    Leila Mokhtari

  2. Department of Operating Room, University of Medical Sciences, Khoy, Iran

    Fatemeh Hosseinzadeh

  3. Department of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran

    Alireza Nourazarian

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  2. Fatemeh Hosseinzadeh
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LM and FH: participated in article writing, AR: involved in article writing and final revision, FH and LM: contributed to drawing the manuscript tables and figures, and AN: consented to the final version of the manuscript.

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Mokhtari, L., Hosseinzadeh, F. & Nourazarian, A. Biochemical implications of robotic surgery: a new frontier in the operating room. J Robotic Surg 18, 91 (2024). https://doi.org/10.1007/s11701-024-01861-6

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