Surgical medicine has undergone a major technological transformation over the last two decades. In this process, which has evolved from open surgeries to laparoscopic procedures and then to robotic surgery, the goal has been to ensure that patients experience less pain, recover in a shorter time, and surgeons can perform more precise procedures. The Da Vinci robotic surgical system is an advanced technological surgical platform used in many branches, primarily urology, and has become one of the standard methods worldwide, especially in prostate, kidney, and bladder surgeries.
What is Da Vinci Robotic Surgery?
Da Vinci is a system where the surgeon sits at a console and performs the surgery through robotic arms under high-resolution three-dimensional imaging. The robotic arms carry mechanical instruments that mimic the surgeon's hand movements one-to-one, but filter out tremors and can move at angles that the human hand cannot reach.
Working Principle
The system consists of three main components: the surgeon console, the patient-side cart, and the imaging unit. The surgeon views the surgical field in up to 10x magnification and in three dimensions through a binocular-like viewer on the console. Hand and finger movements are detected by sensors, processed digitally, and transmitted to the robotic arms. The robot is not a device that makes decisions on its own; every movement is under the control of the surgeon.
In Which Diseases Is It Used?
The Da Vinci system provides a great advantage, especially in narrow and delicate anatomical regions and in surgeries where the preservation of nerves and vessels is critical. The main areas of application in urology are as follows:
- Radical prostatectomy in the treatment of prostate cancer
- Partial or radical nephrectomy for kidney cancer
- Radical cystectomy and neobladder construction in bladder cancer
- Repair of ureteropelvic junction obstruction (UPJ obstruction)
- Removal of adrenal gland tumors
- Vesicoureteral reflux corrective operations
- Selected interventions in complex kidney stone cases
Advantages of Da Vinci Robotic Surgery
Robotic surgery offers significant advantages for both the surgeon and the patient:
- The opportunity to work much more precisely with three-dimensional, high-magnification imaging
- Maneuverability beyond the human wrist thanks to the robotic arms' ability to rotate up to 540 degrees
- Filtering and minimizing the surgeon's natural hand tremors
- Reduced risk of bleeding and less need for blood transfusion due to smaller incisions
- Better preservation of critical nerves for urinary continence and sexual function in prostate surgeries
- Lower infection rate and less pain
- Shorter hospital stay and faster return to daily life
- Aesthetically smaller and less noticeable surgical scars
Treatment Process
A detailed evaluation is performed before robotic surgery. Preparation stages such as blood tests, imaging studies, and cardiology consultation are completed. The patient is given general anesthesia, and several small 1-2 cm incisions are made in the abdominal region. The robotic arms and camera are inserted through these incisions. The surgeon moves to the console and manages the operation. The duration of the procedure may vary between 2 and 5 hours depending on the type of surgery.
Post-Surgery
Patients are usually mobilized on the first day after surgery and are started on nutrition quickly. The length of hospital stay is limited to 2-4 days in most cases. Full recovery and return to strenuous activities are achieved within 3-4 weeks. Oncological and functional results after surgery are followed up with regular check-ups.
Points to Consider
- Robotic surgery may not be the most suitable method for every patient; the decision must be made by an expert urologist.
- Additional evaluation regarding anesthesia may be required for individuals with advanced heart and lung disease.
- Blood thinners used before surgery should be regulated based on physician recommendations.
- Heavy lifting and excessively strenuous activities should be avoided during the recovery period.
- Regular attendance at recommended check-ups is critical for treatment success.
Difference of Robotic Surgery from Open and Laparoscopic Surgery
In open surgery, a long incision is made in the abdominal region, and the surgeon performs the operation directly with their hands. In laparoscopic surgery, work is done with long instruments through a few small incisions; however, the maneuverability of the instruments is limited. In robotic surgery, while small incisions are maintained, the surgeon's freedom of movement is even greater compared to the human hand because the robotic arms can rotate up to 540 degrees.
This superiority provides a distinct advantage, especially in nerve-sparing procedures such as prostate removal. Recovery rates in surgeries performed with the robotic method are quite promising in terms of urinary continence and the preservation of sexual functions.
Frequently Asked Questions
- Does the robot perform the surgery? No; the robot is merely a tool that transmits the surgeon's movements precisely. The surgeon makes all decisions and movements.
- Is it suitable for every patient? The decision is made by evaluating general health status, the structure of the tumor, and previous surgeries.
- How long is the recovery time? Most patients return to their daily lives within 3-4 weeks.
- Are oncological results different from open surgery? In robotic surgery performed with the correct indication, oncological results are at least as successful as open surgery.
Patient Satisfaction and Long-Term Results in Robotic Surgery
Patient satisfaction in urological surgeries performed with the Da Vinci robotic surgical system is at a very high level worldwide. Oncological success rates are similar to or even better than open and laparoscopic surgery; moreover, the side effect profile is much more advantageous. Robotic surgery provides a distinct superiority in results that directly affect the quality of life, such as the recovery of urinary control and the preservation of sexual functions, especially after radical prostatectomy.
Multidisciplinary follow-up requires the urology, oncology, radiology, and pathology teams to work together. The treatment plan, shaped by tumor board decisions, is determined according to the patient's individual risk level. Long-term post-operative follow-up is of critical importance both for the non-recurrence of the disease and for the patient's comfort of life.
Da Vinci Robotic Surgery at Koru Hospital
As Koru Hospital, we offer the Da Vinci robotic surgical system to our patients in the treatment of urological cancers and complex urological problems, together with our experienced urology team. With our modern operating room infrastructure, anesthesia and intensive care support, and multidisciplinary oncology board, we prepare personalized treatment plans for each patient and aim to offer all the advantages of minimally invasive surgery with high standards and safety.
