Dr. Koh Answers Questions About Robotic Surgery

Published on 
June 21, 2010

People unfamiliar with robotic surgery hear the word "robot" and visualize scenes from science fiction movies. To help parents understand how such a high-tech medical tool represents such a helpful surgical instrument, especially for children, the director of our Robotic Surgery Program, Dr. Chester Koh, answered the following four questions that parents ask him:

1) Who Performs the Surgery?  The Robot or the Surgeon? The surgery is always performed by the surgeon.  Our Da Vinci surgical robot cannot make a single move without a surgeon guiding its "arms" through the surgical process with ultra-precise maneuvers to ensure that every incision is exact and as small as possible to speed recovery.

2) What makes robotic-assisted laparoscopic surgery different than "regular" laparoscopic surgery? It comes down to range of motion.  In laparoscopic surgery, the instruments are limited in their movements.  However, the ends of the robot’s arms have "Endowrist" technology (meaning that the tiny ends of the robot’s arms have the same flexibility as human hands to perform complex maneuvers inside a child’s body, like suturing). 

(Pictures courtesy of Intuitive Surgical)

What this means for our patients is that performing reconstructive surgery through the tiny incisions associated with robotic surgery results in more precise surgical procedures than with regular laparoscopic surgery.   More exact movements by the surgeon usually result in a more accurate and safe surgery.

3) What should I look for when deciding where to have minimally-invasive or robotic surgery? When it comes to surgery, better health outcomes and fewer complications are usually associated with surgeons who have completed a higher number of procedures.  In January 2010, our hospital surpassed a major milestone by performing our 100th robotic surgery only 18 months after the arrival of our pediatric robot.  We're delighted to be a major center for robotic surgery in children.

4)  What other options should I consider for my child? Newer methods of surgery are always being investigated and tested and minimally invasive surgery is even more crucial for children than it is for adults.  I’m proud that our hospital is already ahead of the curve in early adoption of minimally invasive surgery for children.  In addition to robotic surgery, other options we provide include:

  • "Belly-button” surgery or "virtually scarless" surgery [also known as "Laparoendoscopic Single Site (LESS) surgery" or "single-incision laparoscopic surgery"(SILS)] where the only incision made is through the belly button.

These newer methods of surgery not only result in great health outcomes, but they also minimize recovery time for a child (in some of our cases, the time required in the hospital to recover prior to going home is 25% of what it would be with a standard surgical approach).  The advantages to a child and to the child’s family of being able to return to life as usual this quickly cannot be overestimated.

Quite simply, what we want most is to help kids live happy, healthy lives, recover as quickly as possible and with the least amount of pain.  And if robots and minimally invasive surgical methods can help us accomplish that, it’s very exciting for me, as a surgeon, to be a part of it.