Skip to main content

Advertisement

SpringerLink
Log in

Robotic surgery: review of the latest advances, risks, and outcomes

  • Review Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Using differing levels of evidence, we developed criteria to critically review 21 scientifically peer-reviewed articles on robot-assisted surgeries in various medical fields. The advantages and limitations of robotic systems are discussed and compared with traditional surgical methods. Since training in the use of robotic skills is essential, various training models are discussed to teach the complex skills necessary for robotic surgery. There is a paucity of control studies on a sufficient number of subjects in robot-assisted surgeries in all fields. Studies that meet more stringent clinical trials criteria show that robot-assisted surgery appears comparable to traditional surgery in terms of feasibility and outcomes but that costs associated with robot-assisted surgery are higher because of longer operating times and expense of equipment. While a limited number of studies on the da Vinci robotic system have proven the benefit of this approach in regard to patient outcomes, including significantly reduced blood loss, lower percentage of postoperative complications, and shorter hospital stays, there are mechanical and institutional risks that must be more fully addressed. In addition, trials are needed to identify simulators for learners that can enhance the da Vinci performance in order to shorten the learning curve.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Advincula AP, Xu X, Goudeau S, Ransom SB (2007) Robot-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparison of short-term surgical outcomes and immediate costs. J Minim Invasive Gynecol 14:698–705

    Article  PubMed  Google Scholar 

  2. Argenziano M, Katz M, Bonatti J, Srivastava S, Murphy D, Poirier R, Loulmet D, Siwek S, Kreaden U, Ligon D, for the TECAB Trial Investigators (2006) Results of the prospective multicenter trial of robotically assisted totally endoscopic coronary artery bypass grafting. Ann Thorac Surg 81:1666–1675

    Google Scholar 

  3. Ayav A, Bresler L, Brunaud L, Boissel P (2004) Early results of one-year robotic surgery using the da Vinci system to perform advanced laparoscopic procedures. J Gastrointest Surg 8:720–726

    Article  PubMed  Google Scholar 

  4. Berryhill R, Jhaveri J, Yadav R, Leung R, Rao S, El-Hakim A, Tewari A (2008) Robotic prostatectomy: a review of outcomes compared with laparoscopic and open approaches. Urology 72:15–23

    Article  PubMed  Google Scholar 

  5. Boggess JF, Gehrig PA, Cantrell L et al (2008) A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy. Am J Obstet Gynecol 199:357.e1–357.e7

    Article  Google Scholar 

  6. Braumann C, Jacobi CA, Menenakos C, Borchert U, Rueckert JC, Mueller JM (2005) Computer-assisted laparoscopic colon resection with the da Vinci® system: our first experiences. Dis Colon Rectum 48:1820–1827

    Article  PubMed  Google Scholar 

  7. Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery. Surg Endosc 19:117–119

    Article  PubMed  CAS  Google Scholar 

  8. D’Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D (2004) Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 47(12):2162–2168

    Article  PubMed  Google Scholar 

  9. Doumerc N, Yuen C, Savdie R, Rahman MB, Rasiah KK, Pe Benito R, Delprado W, Matthews J, Haynes A, Stricker PD (2010) Should experienced open prostatic surgeons convert to robotic surgery? The real learning curve for one surgeon over 3 years. BJU Int 106:378–384

    Article  PubMed  Google Scholar 

  10. Draaisma WA, Ruurda JP, Scheffer RCH, Simmermacher RKJ, Gooszen HG, Rijnhart-de Jon HG, Buskens E, Broeders IAMJ (2006) Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastroesophageal reflux disease. Br J Surg 93:1351–1359

    Article  PubMed  CAS  Google Scholar 

  11. Evans D (2003) Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. J Clin Nurs 12:77–84

    Article  PubMed  Google Scholar 

  12. Folliguet T, Vanhuyse F, Constantino X, Realli M, Laborde F (2006) Mitral valve repair robotic versus sternotomy. Eur J Cardiothorac Surg 29:362–366

    Article  PubMed  Google Scholar 

  13. Franco I, Dyer LL, Zelkovic P (2007) Laparoscopic pyeloplasty in the pediatric patient: hand sewn anastomosis versus robotic assisted anastomosis—is there a difference? J Urol 178:1483–1486

    Article  PubMed  Google Scholar 

  14. Geller EJ, Siddiqui NY, Wu JM, Visco AG (2008) Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol 112(6):1201–1206

    Article  PubMed  Google Scholar 

  15. Hartmann J, Jacobi CA, Menenakos C, Ismail M, Braumann C (2008) Surgical treatment of gastroesophageal reflux disease and upside-down stomach using the da Vinci® robotic system. A prospective study. J Gastrointest Surg 12:504–509

    Article  PubMed  Google Scholar 

  16. Hemal AK, Kolla SB, Wadhwa P (2008) First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system. J Robot Surg 2:35–40

    Article  Google Scholar 

  17. Hernandez JD, Bann SD, Munz Y, Moorthy K, Datta V, Martin S, Dosis A, Bello F, Darzi A, Rockall T (2004) Qualitative and quantitative analysis of the learning curve of a simulated surgical task on the da Vinci system. Surg Endosc 18:372–378

    Article  PubMed  CAS  Google Scholar 

  18. Herron DM, Marohn M, The SAGES-MIRA Robotic Surgery Consensus Group (2008) A consensus document on robotic surgery. Surg Endosc 22:313–325

    Article  PubMed  CAS  Google Scholar 

  19. Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 17:1595–1599

    Article  PubMed  CAS  Google Scholar 

  20. Jung YW, Lee DW, Kim SW, Nam EJ, Kim JH, Kim JW, Kim YT (2010) Robot-assisted staging using three robotic arms for endometrial cancer: comparison to laparoscopy and laparotomy at a single institution. J Surg Oncol 101(2):116–121

    PubMed  Google Scholar 

  21. Katsavelis D, Siu KC, Brown-Clerk B, Lee IH, Lee YK, Oleynikov O, Stergio N (2009) Validated robotic laparoscopic surgical training in a virtual-reality environment. Surg Endosc 23:66–73

    Article  PubMed  Google Scholar 

  22. Krambeck AE, DiMarco DS, Rangel LJ, Bergstralh EJ, Myers RP, Blute ME, Gettman MT (2009) Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int 103:448–453

    Article  PubMed  Google Scholar 

  23. Lee RS, Retik AB, Borer JG, Peters CA (2006) Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol 175:683–687

    Article  PubMed  Google Scholar 

  24. Lowe MP, Chamberlain DH, Kamelle SA, Johnson PR, Tillmanns TD (2009) A multi-institutional experience with robotic-assisted radical hysterectomy for early stage cervical cancer. Gynecol Oncol 113(2009):191–194

    Article  PubMed  Google Scholar 

  25. Marecik SJ, Prasad LM, Park JJ, Pearl RK, Evenhouse J, Shah A, Khan K, Abcarian H (2008) A lifelike patient simulator for teaching robotic colorectal surgery: how to acquire skills for robotic rectal dissection. Surg Endosc 22:1876–1881

    Article  PubMed  CAS  Google Scholar 

  26. McDougall EM (2007) Validation of surgical simulators. J Endourol 21(3):244–247

    Article  PubMed  Google Scholar 

  27. Maggioni A, Minig L, Zanagnolo V, Peiretti M, Sanguineti F, Bocciolone L, Colombo N, Landoni F, Roviglione G, Vélez JI (2009) Robotic approach for cervical cancer: comparison with laparotomy: a case control study. Gynecol Oncol 115:60–64.

    Google Scholar 

  28. Mehrabi A, Yetimoglu CL, Nickkholgh A, Kashfi A, Kienle P, Konstantinides L, Ahmadi MR, Fonouni H, Schemmer P, Friess H, Gebhard MM, Buchler MW, Schmidt J, Gutt CN (2006) Development and evaluation of a training module for the clinical introduction of the da Vinci robotic system in visceral and vascular surgery. Surg Endosc 20:1376–1382

    Article  PubMed  CAS  Google Scholar 

  29. Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F (2006) Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg 93:553–558

    Article  PubMed  CAS  Google Scholar 

  30. Muacevic A, Drexler C, Kufeld M, Romanelli P, Duerr HJ, Wowra B (2009) Fiducial-free real-time image-guided robotic radiosurgery for tumors of the sacrum/pelvis. Radiother Oncol 93(1):37–44

    Article  PubMed  Google Scholar 

  31. Nezhat C, Morozov V (2010) Robot-assisted laparoscopic presacral neurectomy: feasibility, techniques, and operative outcomes. J Minim Invasive Gynecol 17:508–512

    Article  PubMed  Google Scholar 

  32. Obermair O, Gebski V, Frumovitz M, Soliman PT, Schmeler KM, Levenback C, Ramirez PT (2008) A phase III randomized clinical trial comparing laparoscopic or robotic radical hysterectomy with abdominal radical hysterectomy in patients with early stage cervical cancer. J Minim Invasive Gynecol 15:584–588

    Article  PubMed  Google Scholar 

  33. Payne TN, Dauterive FR, Pitter MC, Giep HN, Giep BN, Grogg TW, Shanbour KA, Goff DW, Hubert HB (2010) Robotically assisted hysterectomy in patients with large uteri. Obstet Gynecol 115(3):535–542

    Article  PubMed  Google Scholar 

  34. Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, Cobelli OD (2009) Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int 104:991–995

    Article  PubMed  Google Scholar 

  35. Roy SN (2006) The risks of laparoscopic surgery: I. Gynecol Surg 3:315–319

    Article  Google Scholar 

  36. Seamon LG, Bryant SA, Rheaume PS, Kimball KJ, Huh WK, Fowler JM, Phillips GS, Cohn DE (2009) Comprehensive surgical staging for endometrial cancer in obese patients. Obstet Gynecol 114:16–21

    PubMed  Google Scholar 

  37. Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, Chandrasekhar P, Wilding GE, Guru KA (2010) Face validation of a novel robotic surgical simulator. Urology 76:357–360

    Google Scholar 

  38. Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211

    Article  PubMed  Google Scholar 

  39. Stadler P, Dvoracek L, Vitasek P, Matous P (2010) Robotic vascular surgery, 150 cases. Int J Med Robot Comput Assist Surg 6(4):394–398

    Google Scholar 

  40. Sung GT, Gill IS (2001) Robotic laparoscopic surgery: a comparison of the da Vinci and Zeus systems. Urology 58:893–898

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA

    Mary Downes Gastrich, Gloria Bachmann & Adrian Balica

  2. Department of Surgery, Division of Urology, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA

    Joseph Barone

  3. Department of Surgery, Division of Cardiothoracic Surgery, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA

    Mark Anderson

Authors
  1. Mary Downes Gastrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph Barone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gloria Bachmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Adrian Balica
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mary Downes Gastrich.

Glossary

Cystectomy

Surgical removal of all or part of the urinary bladder

Pyeloplasty

Kidney surgery to reconstruct a damaged ureter and the renal pelvis

Myomectomy (sometimes also fibroidectomy)

Surgical removal of uterine leiomyomas, also known as fibroids

Fundoplication

Nissen fundoplication is a surgical procedure used to treat gastroesophageal reflux disease (GORD) and hiatus hernia

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gastrich, M.D., Barone, J., Bachmann, G. et al. Robotic surgery: review of the latest advances, risks, and outcomes. J Robotic Surg 5, 79–97 (2011). https://doi.org/10.1007/s11701-011-0246-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-011-0246-y

Keywords

Search

Navigation