Robots increasingly playing a part in surgery

Image 1 of 8

Todd Oberle, Medical Director of Georgia Urology, says the first thing you should know about robotic surgery is there is no actual robot in the OR calling the shots

"It is an instrument that the physician uses," Dr. Oberle says ."So, what's important here is not the sophistication of the race car, it's the driver."

Oberle has been the "driver" on more than 500 robotic-assisted laparoscopic surgeries for patients with more complex prostate, bladder, kidney, and adrenal cancers. 

Instead of standing over the patient, he sits at a console a few feet away, remotely controlling a series of tools mounted on robotic arms that mimic his hand movements.

"Instead of being a two-armed surgery I'm a three-armed surgeon," Oberly says.  "That, coupled with 15 times magnification and 3D view, I'm able to see a lot better."

That's important, he says, when it comes to more complex surgical cases.

Dr. Barry Zisholtz, another Georgia Urology surgeon, takes a more hands-on approach, with "open" surgery,

sometimes using scopes.

"So, open surgery, you can feel the surrounding organs," Zisholtz says.  "You have tactile feeling."

Dr. Zisholtz says you can't get that sitting at a console.

Yet, Dr. Oberle says there are undisputed advantages to robotic-assisted laparoscopy, especially with more complex cases. 

"Decrease blood loss is not in question," he says.  "Decreased hospital stay is not in question. Decreased pain after surgery is not in question."

The research findings comparing robotic assisted surgeries to open procedures are mixed.

While patients may recover more quickly, there is little evidence of long-term benefits of robotic-assisted procedures.

 "When it comes to prostate surgery, most of the studies show that at 30 to 60 days, the results are about equal," Dr. Zisholtz says.

Oberle, who performs about 5 to 6 robotic-assisted laparoscopic procedures a week, says the robotic devices give him one more option to help his patients.

"I will tell you as an open surgery and a robotic surgeon, I would prefer to have that tool," Dr. Oberle says. "That tool, just like every tool, is not good for every application.  And so the other thing it's important to understand is which surgeries are we talking about?

If you're considering robotic surgery, both doctors agree experience matters, so ask your doctor questions.

Look for a surgeon who performs your type of procedure regularly.

"The learning cure for a robotic or laparoscopic surgeon is much higher that when we were training for open surgery," Dr. Zisholtz says.  "Some studies show you need to have 200-300 cases of robotic surgery until you're really good at it, whereas open surgery, it is looked at as maybe 10 to 15."