The Pros and Cons of Robotic Surgery
What you should know before going under the remote-controlled knife
Exerpt from article by STEWART PINKERTON

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You’d be forgiven for some hesitation.

Every patient profile is different, and a robot is just another surgical instrument: It’s only as good as the surgeon using it.
Before making a decision on what kind of procedure to elect, here are some things to consider:

Why the spike in robotic usage?
Back in 2000, there were only 1,000 robotic surgeries world-wide. That number surged to 360,000 in 2011 and 450,000 in 2012. Boosters say the practice is on the rise because of its strong benefits. For the patient, there’s usually less blood loss, a shorter hospital stay and less reliance on postoperative pain medication. There’s also the cosmetic benefit of no big scars: As in laparoscopic surgery, the instruments enter the body through small incisions.

For surgeons, the procedures can be less tiring. They don’t have to bend over an operating table—they can sit in front of a screen with a magnified, full-color 3-D view of the surgical field. For maneuvering in very tight spaces, like the back of the throat, the enhanced screen image makes it “much easier to see what I’m doing,” says Eric Genden, chief of otolaryngology at New York’s Mount Sinai Hospital.

But some doctors say robotics is catching on not just because of its merits—there’s a “wow” factor at work. Martin Makary, a pancreatic surgeon at Johns Hopkins, believes the technique is safe and useful for certain procedures.
“As with any new technology, care should be taken that protocols are in place to ensure appropriate patient selection and the full explanation of risks and benefits for all surgical options.”

How should patients decide?

The wisest approach is to have your surgeon explain the alternative procedures, including typical postoperative scenarios and why the suggested approach is the best option in your particular case. No single approach is a one-size-fits-all answer for all conditions requiring surgery.

How much training is required to perform robotic surgery?
Dr. Makary, the Johns Hopkins surgeon, believes that overall, robotic surgery is safe. But, he says, problems can get magnified if a surgeon doesn’t have advanced laparoscopic surgical skills to begin with and doesn’t have full command of the device. That means it’s easier to cause inadvertent injury.

Obviously, ask your surgeon how experienced he or she is in the procedure and whether there have ever been any complications. Good question for the hospital, too.