cessfully done bariatric procedures, gallbladders, different types of
hernias, appendectomies — bread-and-butter stuff.
Just as minimally invasive laparoscopy became a preferred option
versus open surgery, robot-assistance is taking us to the next level of
care. The Senhance robotic system simply builds upon and refines the
foundation of laparoscopy. With laparoscopy, surgeons take handheld
instruments and, through the use of trocars, insert them (instead of
our hands) into the body. We manipulate the instruments and do the
operation — dissection, vessel sealing, and so on. The robot adds a
digital interface. We're still putting instruments into the patient, but
the way I control them is a bit different.
To me, robots give you several advantages over manual laparoscopy:
• Ergonomics. It's easy to forget the physical toll laparoscopy can
take on a surgeon. Using the robot for prolonged cases is far less
fatiguing. You're sitting at a console, in a chair, instead of standing at
the patient's bedside.
• Visualization. The more visual information available to the sur-
geon, the better and faster the procedure will go. With traditional
laparoscopy, you have a 2-dimensional image on the screen. With the
Senhance, I see a 3D image through a pair of wraparound glasses.
This has huge advantages when you're doing dissection. Because I
can see things like the gallbladder or hernia in 3D, I get the depth per-
ception needed to make fine movements.
• Refinement of techniques. The digital interface of the robot trans-
lates your motions and cleans them up a bit. It removes tremors and
vibrations that could potentially affect outcomes.
• Theoretical advantages. In traditional laparoscopy, we torque
against the patient's abdominal wall, and move the instruments around
as we see fit. With the robot, the instrument deploys less torque, which
reduces patient discomfort.
4 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 9
