The most well-known surgical robots currently available feature three independent arms that, under human direction, enter patients through three separate cuts and then triangulate on the target area.
Image Credit: Ilya Lukichev/Shutterstock.com
The next-generation robots bundle those three arms as well as a camera into a single cylinder or port that permeates the body via a single 2-inch incision. In addition, the camera and arms spread out adjacent to the surgical site to do their task.
Normally, robotic-assisted surgeries cut less tissue than traditional, open-incision surgeries because their robotic arms access tissue through small holes, but the latest robots cut even less.
Two of the four such robots in New Jersey are in the hands of Rutgers doctors.
Robotic surgery has several advantages over open surgery. Patients benefit from less blood loss, spend fewer nights in the hospital and minimize or even avoid narcotic pain medication after they go home.
Evan Kovac, Associate Professor, Urology, New Jersey Medical School, Rutgers University-New Brunswick
Kovac is one of the first at his institution to start utilizing the new device.
Kovac added, “The single-port robot is the next technological step, even better than its multi-port predecessors because it is even less invasive. Many cancer operations that have always required overnight hospital stays can be done as outpatient procedures.”
The results must improve as early adopters devise and publish best practices for several procedures.
Kovac, for example, uses the novel technology to access the prostate without first cutting through the abdominal cavity, which reduces pain and the risk of bowel injury. Access into tight spaces that would be unreachable with the multi-port robot is made possible by all three robotic arms entering the body through a single location.
Sammy Elsamra, an associate professor of urology at Robert Wood Johnson Medical School, has used the restricted footprint of the single-port robot to evaluate the space behind the peritoneum for several surgeries. These special procedures are being presented at the American Urologic Association annual meeting in 2023.
The single-port robot may not replace the three-port robot for all surgeries, though early adopters, like those at Rutgers, are working towards developing and improving upon new techniques for this new system. We’re also tracking outcomes to publish comparisons with outcomes from the three-arm robots.
Sammy Elsamra, Associate Professor, Urology, Robert Wood Johnson Medical School, Rutgers University-New Brunswick
Urology and ear-nose-and-throat residents at both medical schools profit from early access to such innovative robots in their training.
Also, the robots offer standard clinical care to patients at University and Robert Wood Johnson hospitals. Till now, the most general procedures are urological, such as partial and entire removal of the prostate or kidneys and urinary reconstructive surgery.
Further, the single-port robot is used by ENT (Ear, Nose, and Throat) for trans-oral robotic surgery for differently inaccessible surgical tasks deep in the throat.
A single entry point also has cosmetic advantages. We can hide the incision scar for many surgeries in the belly button or under their waistline, thus improving overall body self-image in addition to superior clinical outcomes.
Sammy Elsamra, Associate Professor, Urology, Robert Wood Johnson Medical School, Rutgers University-New Brunswick