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Robot-assisted laparoscopy

Marie Fidela R Paraiso, MD, FACOG
Tommaso Falcone, MD, FRCSC, FACOG
Section Editors
William J Mann, Jr, MD
Jeffrey Marks, MD
Deputy Editor
Kristen Eckler, MD, FACOG


A surgical robot is a computer-controlled device that can be programmed to aid the positioning and manipulation of surgical instruments. Surgical robotics is typically used in laparoscopy rather than open surgical approaches. Since the 1980s, surgical robots have been developed to address the limitations of laparoscopy, including two-dimensional visualization, incomplete articulation of instruments, and ergonomic limitations. The goal of robot-assisted laparoscopic surgery is to help surgeons improve patient care by converting procedures that would have otherwise been performed by laparotomy into minimally invasive procedures. Robot-assisted laparoscopic surgery has all of the advantages of minimally invasive surgery include less postoperative pain, smaller and possibly more cosmetically appealing incisions, shorter hospital stay, shorter recovery time, and faster return to work.

In its initial phase, robotic procedures were performed almost exclusively by surgeons with advanced laparoscopic skills. However, since the da Vinci robot (one type of robotic surgical platform) was approved by the US Food and Drug Administration (FDA) for use in gynecologic surgery, there has been rapid adoption of robot-assisted laparoscopic procedures in gynecology by surgeons of all skill levels. Based upon data published in 2008 [1], there were more than 645 da Vinci systems in use worldwide and, since then, there continued to be an exponential rise in the use of these surgical systems to 3477 units by late 2014 [2]. Barriers to the adoption of robotics in surgery include the expense, training requirements for physicians and nurses, and lack of high quality data. Similar to conventional laparoscopy, robot-assisted laparoscopy has been widely adopted prior to emergence of data supporting efficacy and safety.

The role of robot-assisted laparoscopy in gynecologic surgery will be reviewed here. Related topics are discussed separately:

General principles of conventional laparoscopic surgery (see "Abdominal access techniques used in laparoscopic surgery")

Single port laparoscopy (see "Abdominal access techniques used in laparoscopic surgery", section on 'Single-incision surgery (SIS)')

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Literature review current through: Nov 2017. | This topic last updated: May 31, 2016.
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