Before the widespread use of Robotic Surgery, Gynaecological Cancer Surgeries were performed by two approaches: Conventional Open Surgery and Laparoscopic (Key Hole Surgery).Open Surgery has its own disadvantages - big scar, prolong recovery, more complications and long hospital stay. To overcome this, Laparoscopic surgery (Key Hole) Surgery was introduced, where the operations are performed through smaller incisions, which resulted in less blood loss, small scars, faster recovery and shorter hospital stay. The laparoscopic surgery has its own disadvantages and is very challenging to perform complex cancer surgeries. Hence, Laparoscopic Surgery was widely used for simple indications, but its use in complex cases was very limited.
Robotic Surgery is a perfect combination of both Conventional Open Surgery and Laparoscopic Surgery. The surgery is performed through keyhole just like laparoscopic surgery, but the instrumentation and the vision is totally different. The Robotic Surgery instruments are Wristed, which means they have a similar flexibility like human wrist as against laparoscopic surgergical instruments where the movements of instruments are restricted. The vision for the surgeon is Three Dimensional (3D), while in conventional laparoscopic surgery it is two dimensional 2D. Three-Dimensional vision is just like what you see in Open Surgery; hence the surgical precision is more with less trauma. This combination of wristed instruments, three dimensional vision, 12 times magnification, makes it a safer alternative to conventional laparoscopy. Also, it makes performance of complex surgeries much easier.
The current data that is available, Robotic Assisted Surgery is equivalent to conventional Open/Laparoscopic Surgery in terms of adequacy of dissection, lymph node retrieval and complications. The conversion rates are actually less with Robotic Surgery than Laparoscopic Surgery. Available data suggests that, Robotic Surgery can be safely recommended to all suitable women with Gynaecological cancers.
With the current available evidence, it can be safely assumed that Robotic (Computer) Assisted Surgery is a safe and viable alternative to Conventional Open and Laparoscopic Surgery. Robotic Surgery provides distinct advantage over Conventional Laparoscopic Surgery as the vision and instrumentation is superior to that used in Laparoscopy. It is important to note that, not all gynaecological cancer patients can be operated using this technique, but a select group of patients can definitely be benefited.