Yonsei Med J.  2008 Dec;49(6):886-890. 10.3349/ymj.2008.49.6.886.

Robotic Surgery in Gynecologic Field

• Kim YT
• Kim SW
• Jung YW

• KMID: 1782934
• DOI: http://doi.org/10.3349/ymj.2008.49.6.886

Abstract

Operative laparoscopy was initially developed in the field of gynecology earlier on and the advent of laparoscopic surgery led to advances in general surgery as well. In the last few years, a number of articles have been published on the performance of surgical procedures using the robot-assisted laparoscopy. The shortcomings of conventional laparoscopy have led to the development of robotic surgical system and future of telerobotic surgery is not far away, enabling a surgeon to operate at a distance from the operating table. The complete loss of tactile sensation is often quoted as a big disadvantage of working with robotic systems. Although the first generation da Vinci robotic surgical system provides improved imaging and instrumentation, the absence of tactile feedback and the high cost of the technology remain as limitations. New generations of the robotic surgical systems have been developed, allowing visualization of preoperative imaging during the operation. Though the introduction of robotics is very recent, the potential for robotics in several specialties is significant. However, the benefit to patients must be carefully evaluated and proven before this technology can become widely accepted in the gynecologic surgery.

Keyword

Robotics; uterine cervical neoplasm; hysterectomy

MeSH Terms

Female
Gynecologic Surgical Procedures/instrumentation/*methods
Humans
Hysterectomy/instrumentation/methods
Robotics/instrumentation/*methods

Figure

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  Fig. 1 Robotic cart with telerobotic arms (da Vinci surgical system); (A) da Vinci robot cart with 4 robotic arms (B) Surgical field; (C and D) Surgeon console. The motion of robotic instrument in the surgical field is operated by both hands.

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  Fig. 2 Inside vision system with endoscope.

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  Fig. 3 Port placement: (A) The 12-mm camera port was placed in the umbilicus or above depending on the size of the uterus. (B) The 8-mm lateral ports for robotic instruments were mounted directly to the robotic arms and placed 2 to 3 cm medial and superior to the anterior superior ileac spine with modification based on the size of the uterus. (C) The assistant port was placed between the camera port and the left lower quadrant port.

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