Our Summary

In recent years, the number of surgeries performed with the help of robots has skyrocketed in Australia and around the world. However, there has been no high-quality research on how this affects the work of anesthesiologists. The research we do have suggests that anesthesiologists face unique challenges in robotic surgeries. While many aspects of their job remain the same, they often have less physical access to the patient and have to deal with extreme body positioning. This can lead to problems like changes in the patient’s bodily functions and even risk of injury. More research is needed to fully understand these issues.

FAQs

  1. What has been the trend in the number of robotic-assisted surgical procedures performed in Australia and internationally over the past decade?
  2. What are some of the specific challenges and considerations for an anaesthetist during robotic-assisted surgeries?
  3. What kind of risks and physiological disturbances can patients experience during robotic-assisted procedures due to the positioning and limited access?

Doctor’s Tip

A helpful tip a doctor might tell a patient about robotic surgery is to follow all pre-operative instructions provided by the surgical team, including fasting guidelines and medication instructions. It is important to communicate any health concerns or allergies to the surgical team before the procedure. Additionally, it is important to follow all post-operative care instructions to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for robotic surgery include those with:

  1. Prostate cancer
  2. Endometrial cancer
  3. Cervical cancer
  4. Uterine fibroids
  5. Kidney disorders
  6. Gallbladder disease
  7. Colorectal cancer
  8. Hiatal hernias
  9. Gynecologic conditions like pelvic organ prolapse
  10. Heart valve diseases

These patients may benefit from robotic surgery due to the minimally invasive nature of the procedure, which can result in shorter hospital stays, less pain, faster recovery, and smaller incisions compared to traditional open surgery. However, it is important to note that each patient’s individual medical history and condition will ultimately determine if they are a good candidate for robotic surgery.

Timeline

Before robotic surgery:

  1. Patient consults with surgeon to discuss treatment options and decides on robotic surgery as the preferred method.
  2. Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for robotic surgery.
  3. Patient receives instructions on pre-operative preparations, such as fasting and medication management.

During robotic surgery:

  1. Patient is brought into the operating room and positioned on the robotic surgical table.
  2. Anaesthesia is administered to induce unconsciousness and pain control.
  3. Surgeon and surgical team use robotic instruments to perform the procedure with precise movements and enhanced visualization.
  4. Anaesthesia team monitors patient’s vital signs and adjusts medications as needed throughout the surgery.

After robotic surgery:

  1. Patient is transferred to the post-anesthesia care unit (PACU) for recovery and monitoring.
  2. Patient may experience pain, nausea, and other side effects from the surgery and anaesthesia.
  3. Patient is discharged home or to a hospital room once stable and comfortable.
  4. Follow-up appointments are scheduled with the surgeon to monitor recovery and address any concerns or complications.

What to Ask Your Doctor

  1. What are the potential benefits of robotic surgery compared to traditional surgery for my specific condition?

  2. What are the potential risks and complications associated with robotic surgery?

  3. How experienced is the surgical team with robotic procedures?

  4. What type of anesthesia will be used during the robotic surgery?

  5. How will my pain be managed after the robotic surgery?

  6. What is the expected recovery time and outcome of the robotic surgery compared to traditional surgery?

  7. Are there any specific pre-operative preparations or restrictions I need to be aware of for robotic surgery?

  8. How long will the robotic surgery take and what is the expected length of hospital stay?

  9. What are the alternatives to robotic surgery for my condition and why is robotic surgery being recommended?

  10. What is the long-term success rate of robotic surgery for my condition?

Reference

Authors: Pathirana S, Kam P. Journal: Anaesth Intensive Care. 2018 Jan;46(1):25-35. doi: 10.1177/0310057X1804600105. PMID: 29361253