Urological surgeries have changed a lot in the last twenty years thanks to robotic surgery. Since its early days in medicine, robotic surgery has expanded the types of treatments that can be performed, most notably the removal of prostate cancer.
What Makes Robotic Surgery Unique?
Robotic surgery is an improvement on keyhole surgery that uses minor cuts, gas to make the work area bigger, and precise tools. It is a common misunderstanding that surgical robots work independently, but surgeons control these tools using a console. The method excels in precision, especially in vascular areas like the pelvis, where it effectively curtails blood loss. The controlled gas expansion and gentle tissue manipulation significantly reduce damage and stress, making healing faster and less painful after surgery.
A large randomised controlled trial published in JAMA in 2022 confirmed the drop in problems. This showed that robotic surgeries are safer and patients recover faster. The study pushed for wider use of robotic surgeries, which have been shown to have good results for patients for ten years.
I am the leading robotic surgeon in day-case robotic prostatectomy in the south of the UK. This is only thanks to the advancement in robotic technology and team collaboration, which allows a patient undergoing a major surgery to go home on the day.
Which Urological Procedures Commonly Employ Robotic Surgery?
Robotic surgery has become very important in urology, especially robotic prostatectomy, which is the primary way that prostate cancer is treated. This method has grown to include techniques that protect nerves and continence, making healing from surgery much faster. Naturally, the robot has been used for other urological cancers, like bladder and kidney cancer.
With its adoption and success, surgeons started looking at other body parts that would benefit. Nowadays, most specialities, like general surgery, ENT, cardiothoracic, gynaecology, and others, emphasise robotic surgery in their practice. It allows for the removal of just a part of the kidney, maintaining optimal cancer treatment outcomes without necessitating the removal of the entire organ.
We've set new standards for treating bladder cancer worldwide, making these complicated procedures more likely to be successful. Working together with gynaecological surgeons to treat pelvic cancer and bladder augmentations shows that robotic surgery is becoming more flexible in urology and related fields.
What new research and developments could make things even better for patients?
Right now, the most fascinating robotic urology research is being done on bladder cancer, especially the cutting-edge IROC multicenter randomised control study published in JAMA in 2022. This groundbreaking study from the UK started a new era by showing that fully robotic bladder surgery is safe and has lower rates of complications. This is the first time this has been done anywhere in the world.
There are many exciting possibilities for future studies that aim to use new technologies to improve existing and new robotic platforms. These aim to enhance energy devices, stapling mechanisms, and other surgical tools so that surgeries are more accurate and patients get better results. The implementation of artificial intelligence will further facilitate pathways and outcomes.
Reflecting on the advancements of robotic surgery in urology.
In summary, robotic surgery is an important step forward in urology that improves patient care through safety, accuracy, and new ideas. Ongoing studies and technological advances especially in the field of artifical intelligence (AI) point to a bright future in which patient outcomes for various urological conditions will improve even more.
