Robotics and Newer Surgical Technologies

Minimally invasive surgery (MIS) describes an approach where major operations are performed through small incisions. MIS encompasses laparoscopy, robotic surgery, and natural orifice transluminal endoscopic surgery (NOTES), surgical techniques that promise to impact the way surgery is practiced. The goal of this chapter is to provide a basic overview of the aforementioned practices and their potential applications.

I

Single-Incision Laparoscopic Surgery

1.
Via an incision at the umbilicus, either several low-profile trocars or a single multilumen trocar is introduced.
2.
It allows the use of conventional laparoscopic instruments while minimizing trauma and surgical scars.
3.
Advantages include less pain, fewer wound complications, quicker return to activity, and better cosmesis.
4.
Disadvantages include cost, ergonomic and technical difficulty, and lack of separate extraction site.
5.
Studies show equivalency between single-incision laparoscopic surgery (SILS) and traditional laparoscopy in terms of complications.
6.
Most common complications are intraabdominal abscess and wound infections.
7.
Common applications include appendectomy, cholecystectomy, and nephrectomy.
8.
In the future, combining SILS with a robotics platform may reduce the operative complexity and improve ergonomics.

II

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