Exploring the Present and Emerging Impact of Surgical Procedures Performed Through a Singular Access Point in Robotics
Single-port robotic surgery, a revolutionary advancement in the field of medicine, is making waves in the surgical world. This innovative technique, which involves a single small incision, is changing the landscape of various procedures, offering improved cosmetic outcomes, patient satisfaction, post-surgical pain, and recovery.
The key differences between single-port and multi-port robotic surgical systems lie in the number and size of incisions, access techniques, and potential patient benefits. Single-port systems, with their one small incision (less than 3 cm), minimize invasiveness, aiming to reduce trauma, pain, and improve cosmetic outcomes. This can lead to quicker recovery and less postoperative discomfort in the short term (first 90 days).
On the other hand, multi-port systems require multiple small incisions. While they offer more flexibility with independently positioned robotic arms and sometimes haptic feedback, enhancing the surgical workspace and surgeon experience, they are more invasive.
Single-port surgery allows for innovative access routes, such as the retroperitoneal approach for kidney surgery or surgery through natural orifices, which are more challenging or not feasible with multi-port systems. This makes single-port surgery particularly promising for urologic surgeries, such as radical prostatectomy and upper urinary tract surgeries, especially in patients with prior abdominal surgeries or scar tissue.
The retroperitoneal approach through a low abdominal incision allows for partial or total kidney removal with minimal visible scarring. Single-port surgery may also be well suited for patients with low BMI, small prostates, or those who cannot tolerate multiple incisions.
Emerging applications of single-port robotic surgery include transvesical approaches for prostate surgery and supine-anterior retroperitoneal approaches, which can extend surgical indications to complex cases. The use case for single-port robotic surgery is evolving and has potential applications in ear, nose, and throat procedures, and even beyond the reach of multi-port systems, such as transvesical cystectomies.
For high-volume surgical centers, the SP robotic system is worth considering as a promising addition to their surgical armamentarium. However, institutions considering acquiring a single-port system should allocate time to assess and identify its full capabilities. The process of triangulating the instruments in the SP system is different due to them branching out from a single trocar.
The dexterity of some instruments can be trickier to grasp and hold using an SP system compared to a multi-port system. To avoid clashing the instruments in the SP system, hand placement on the controls is different compared to multi-port systems. Training models are being developed to facilitate the adoption of the SP robotic system.
The SP system's smaller instruments, along with improved optics, enhance the precision of the system and enable surgeons to perform complex surgeries in more confined spaces. For certain procedures, such as simple prostatectomies, the SP robot has become the preferred mode of intervention using the transvesical route.
A recently developed access kit for the SP system acts as an extension of the abdominal cavity, making it easier to assess cancer margins. This development further solidifies the potential of single-port robotic surgery in cancer surgeries.
In summary, single-port robotic surgery, with its minimally invasive approach, shows promise, particularly in urologic procedures with complex anatomical challenges or prior surgeries. Multi-port systems offer greater instrument flexibility but require multiple access points. The choice often depends on surgeon expertise, patient factors, and specific procedural requirements.
Science and technology have played significant roles in the development of single-port robotic surgery, offering a less invasive approach for various medical-conditions, especially in urologic surgeries. Financial considerations also come into play for high-volume surgical centers, as they may find the SP robotic system a promising addition to their health-and-wellness services, thanks to its potential to streamline procedures and improve patient outcomes.
