Global Health Asia-Pacific Special Issue | Page 29

conditions associated with prolonged bed rest , such as deep vein thrombosis , lung infections , urinary tract infections , and post-operative deconditioning . Reduced pain enables patients to walk around even during the early days post-surgery .
Robotic instruments Recent years saw the tremendous development of modern robotic systems designed to undertake conventional laparoscopic techniques . These latest systems have given surgeons improved tools to perform resections for colorectal cancers in every segment of the colon and rectum , according to Dr Koh who has practised robotic surgery since 2008 . This is due to new designs of the patient side cart and the robotic instruments , which have improved dexterity and motion range . He added that this feature allows the robotic system to be easily manoeuvrable with little external collisions of the arms during surgery .
While Dr Koh assures that experienced surgeons can successfully use robotic tools for all colorectal cancers that can be treated with laparoscopic surgery , there are exceptional circumstances where both minimally-invasive approaches are inapplicable . One example is the case of a large colorectal tumour that has spread to other surrounding organs , leading to serious health problems like bowel obstruction .
Robotic system components outperform standard laparoscopy Research shows that patients who undergo minimally invasive procedures have lower levels of blood markers such as C-reactive protein ( CRP ) and interleukin ( IL ), indicating they experienced reduction in surgically induced trauma compared to patients treated with conventional surgery . And robotic procedures can outperform standard laparoscopy because they provide improved optical vision , accuracy and optimal magnification of the internal tissues .
The standard robotic system comprises an optical camera system and three operating arms , which a single user can handle . The optical camera system comprises of a dual-lens device with multiple imaging features such as high-definition image quality , 3D visualisation and 10X magnification power . Furthermore , mechanical aspects such as motion scaling and tremor dampening provide an operating tool that is more stable than human wrists while conducting surgery .
Robotic surgery has also been demonstrated to significantly reduce surgeon fatigue . Unlike open surgery and standard laparoscopy where surgeons are constantly holding surgical tools and stand for long hours throughout the procedure , robotic surgery allows them to be comfortably seated at the console cart while operating robotic arms that emulate surgeon hand movements but with enhanced dexterity and precise micro-movements in conducting incisions , Dr Koh explained . For example , a recent pilot study determined that primary surgeons who practised robotic surgery displayed less hand and
Robotic system components outperform standard laparoscopy
torso muscle fatigue compared to those conducting laparoscopy .
The seamless function of all robotic system components simultaneously translates into a more precise and accurate surgical work and enhanced safety due to a lower risk of damaging organs during resection . This means that robotic surgery is always preferable to standard laparoscopy for surgeons who are well versed in using robotic instruments .
Treatment outcomes of robotic surgery In general , robotic surgery and laparoscopy lead to comparable disease-free survival and recurrence rates in colorectal cancer patients treated by experienced surgeons . Various studies have demonstrated that both approaches produce excellent disease management results and a favorable disease-free survival rate , especially in the early stages of cancer . It is essential to acknowledge that these comparative studies between open surgery , laparoscopy , and robotic surgery have shown that the three surgical approaches are similar in terms of treatment outcomes . But they have also proved that minimally invasive procedures benefit patients by improving recovery and minimising the risk of perioperative complications for patients without affecting their chances of survival .
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Laparoscopic surgeries have reduced the duration of hospital stays to three / five days .
GlobalHealthAndTravel . com ISSUE 6 | 2022