Robotic Surgery Technique Provides Less Trauma and Greater Precision in Operations
The Department of Obstetrics and Gynecology at the Hospital das Clínicas of the USP School of Medicine is starting to offer robotic surgeries to serve the general public. The technology provides minimally invasive surgeries with greater precision and less impact on the body. It can be used, for example, to remove the uterus, treat endometriosis, remove cancers and other diseases. Sérgio Contes Ribeiro, head of the Gynecological Laparoscopy (the name of the robotic technique) group at the Hospital das Clínicas, explains, in general terms, how the treatment works: “The surgeon sits at a console and, through movements with his fingers, he coordinates the robotic arms that are close to the patient. It is truly a surgery that provides great safety for our women who need to undergo some gynecological surgical treatment procedure”, he adds.
Typically, three small holes are made in the abdomen so that the cameras can have better access to the area. A cut of approximately one centimeter is made in the navel and two smaller ones nearby. Robotic “hands” pass through these holes, which can operate on the patient from the inside with greater precision than even the best surgeons can offer. A tiny camera is also passed through so that the doctor can monitor the situation, but it can magnify the image by up to 20 times.
Less invasive
The doctor comments that, if the surgery is well indicated and the pre-operative care is carried out properly, robotic surgery “is a much better alternative”. Not only because of the better surgical technique, but also because of the better recovery and quality of life of the patient. “The patient is discharged, sometimes, on the same day or the next morning. Imagine a person who needs to go back to work in five or seven days, who is free to resume their usual professional activities”, says Ribeiro.
Still, it is still surgery, and some rest is necessary. After all, it prevents damage to the external part of the body, but there has still been invasion of the internal part. “The extent of the surgery internally is the same as when we performed open-belly surgery.” There may also be cases, according to the doctor, in which the doctor opts for the old technique if he deems it necessary. In general, however, the benefits of using robots should outweigh any adversity.
What still needs to be developed
The first drawback is the cost, which, because it requires cutting-edge technology, is still very high. For this reason, it may take some time for the technique to become widespread and widely accessible, initially being restricted to the main medical centers.
A second point of attention is learning the technique. At USP, for example, those graduating in surgery must complete the previously required three years of residency and two additional years, created specifically to learn how to use the equipment. But the idea is that these are not separate learning experiences: “We believe it is very important to provide training throughout the residency. In addition, there are postgraduate courses and extension courses that are offered to other colleagues who did not have this opportunity during their residency to train in minimally invasive surgery, and these extension courses try to fill this gap in the training of these colleagues. But the ideal would be for all residencies to include this training in minimally invasive surgery as part of their program.”