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| EDITORIAL |
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| Year : 2023 | Volume
: 6
| Issue : 2 | Page : 37-38 |
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Advancing precision and patient care: The rise of robotic thoracic surgery
Ajay Narasimhan
Department of Thoracic Surgery, Apollo Hospitals, Chennai, Tamil Nadu, India
| Date of Submission | 30-May-2023 |
| Date of Decision | 15-Jun-2023 |
| Date of Acceptance | 16-Jun-2023 |
| Date of Web Publication | 13-Jul-2023 |
Correspondence Address:
Dr. Ajay Narasimhan
2A Lahari Apartments, 18/22 Wallace Garden III Street, Nungambakkam, Chennai - 600 006, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/japt.japt_22_23
How to cite this article:
Narasimhan A. Advancing precision and patient care: The rise of robotic thoracic surgery. J Assoc Pulmonologist Tamilnadu 2023;6:37-8 |
How to cite this URL:
Narasimhan A. Advancing precision and patient care: The rise of robotic thoracic surgery. J Assoc Pulmonologist Tamilnadu [serial online] 2023 [cited 2023 Sep 30];6:37-8. Available from: https://www.japt.in//text.asp?2023/6/2/37/381418 |
The term robot is originally derived from the Czech word Robota meaning “labor.”[1] Medical advancements continue to revolutionize the field of surgery, and one notable innovation is robotic thoracic surgery. Even though robots have been used in the manufacturing industry since the 1950s, it was not until 1990 that they entered the medical field. Robotic surgeries have revolutionized the way complex thoracic procedures are performed, offering a lot of advantages over traditional open surgery. This cutting-edge approach combines the skill of a surgeon with the precision of robotic technology, enhancing patient outcomes, and transforming the way thoracic procedures are performed. Robotic-assisted surgery has gained recognition for its ability to minimize invasiveness, enhance surgical precision, and shorten recovery times. In this article, we will explore the benefits and applications of robotic thoracic surgery. The popular surgical robots available in the market are da Vinci by intuitive surgical, Hugo by Medtronic, Versius by CMR Surgical, and SSI Mantra from SS Innovations.
Most of the robotic systems today have three parts – the master console, the vision cart, and the surgical cart. The master console is the place from where the surgeon operates. The vision cart contains the housing unit for the telescope and helps the bedside assistant visualize the surgery. The surgical cart is the main unit from where the robotic arms originate and are used in the surgical procedure.[2]
Robotic thoracic surgery utilizes 3–4 robotic arms controlled by a surgeon to perform complex procedures with unparalleled precision. These robotic arms are equipped with miniature instruments and a high-definition 3D camera that provides the surgeon with a magnified, detailed view of the surgical site. The robotic arms have degrees of freedom very similar to the human wrist, all the movements happening inside the patient's chest. This enhanced vision, combined with the robotic arms' ability to rotate 360° and scale down hand movements, allows surgeons to navigate tight spaces with greater ease and perform intricate maneuvers with exceptional precision. The filtration of tremors gives the surgeon a greater degree of stability while operating.
Endostaplers play an important role in minimally invasive thoracic surgery. They are used in tackling the pulmonary arteries, veins, bronchi, and fissures. They are specialized devices which divide the tissues by stapling them on either side and cutting them in the middle. Da Vinci by intuitive surgical has their own stapler which is known as SureForm which is integrated with the robotic arms. This stapler also has an EndoWrist capability. The staplers are available in different sizes and colors such depending on the thickness of the tissue about to be stapled. The robotic staplers use artificial intelligence while stapling. For instance, if the tissue is too thick, the stapler automatically pauses for compression and then continues firing.
One of the primary advantages of robotic thoracic surgery is its minimally invasive nature. Traditional open thoracic surgery involves a large incision, leading to prolonged hospital stays, a higher risk of infection, and significant postoperative pain. Robotic-assisted surgery, on the other hand, uses small incisions, enabling surgeons to access the thoracic cavity with minimal disruption to surrounding tissues. This leads to reduced blood loss, lower risk of infection, faster recovery times, and smaller scars, greatly improving patient comfort and cosmetic outcomes.
With the advent of uniportal robotic thoracic surgery, we are now able to combine the advantage of a single incision with the precision of a surgical robot. This is advantageous over conventional robotic surgery that there is only one scar over the chest and the specimen can be extracted through the same incision without the need to extend one of the ports.
Robotic technology has expanded the range of thoracic procedures that can be performed using minimally invasive techniques. Complex operations such as lung resections, lobectomies, and thymectomies can now be accomplished with greater precision and safety through robotic-assisted approaches. The robotic system's flexibility allows surgeons to access hard-to-reach areas of the chest with greater ease, enhancing their ability to remove tumors and perform delicate surgical tasks. The surgical robot is particularly useful in performing complex thoracic surgeries such as sleeve resections.
The main drawback of robotic surgery is the absence of tactile feedback. This can be unsettling in the beginning especially because the surgeon is away from the patient. However, with increasing advances in artificial intelligence, one might hope that the technology to provide tactical feedback is soon introduced into the surgical robot.
The other main drawback is the cost of surgery. Cost of surgery may be increased due to various factors. The cost of robotic instruments and longer operative times play a major role in this.
Robotic thoracic surgery represents a significant milestone in the field of surgical innovation, providing patients with a safer, more precise, and less invasive option for thoracic procedures. With enhanced surgical precision, shorter recovery times, and improved patient outcomes, the adoption of robotic technology is reshaping the way thoracic surgeries are performed. As the field continues to evolve, it is likely that robotic-assisted procedures will become more commonplace and more affordable, further advancing the quality of care provided to patients with thoracic conditions.
| References | |  |
| 1. | Morrell AL, Morrell-Junior AC, Morrell AG, Mendes JM, Tustumi F, DE-Oliveira-E-Silva LG, et al. The history of robotic surgery and its evolution: When illusion becomes reality. Rev Col Bras Cir 2021;48:e20202798.  |
| 2. | Zirafa CC, Romano G, Key TH, Davini F, Melfi F. The evolution of robotic thoracic surgery. Ann Cardiothorac Surg 2019;8:210-7. |
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