Robotic Surgery (da Vinci)

Robotic surgery, often known by the name of the most widely used platform, is a way of performing keyhole operations with greater precision and control. The surgeon sits at a console a few steps from the operating table and looks into a high-definition, magnified three-dimensional view of the surgical field. Hand and finger movements at the console are scaled down and steadied, then carried out by slim instruments on robotic arms passed through small incisions, each with a wrist that bends and rotates far beyond what the human hand can do inside the body. It is not a separate disease treatment but a refined surgical method, an evolution of laparoscopy, used to carry out many established operations through smaller wounds with finer control.

The robotic approach is considered when an operation can be done through small incisions and would benefit from precise dissection, careful preservation of nerves and fine suturing in a deep or narrow space. It is well suited to operations in the pelvis and abdomen, where the magnified view and wristed instruments help protect important structures. Common examples include removal of the prostate for cancer with preservation of the nerves that control continence and erection, kidney-sparing removal of a tumour, removal of the womb or fibroids, surgery for endometriosis, and bowel cancer surgery, among others. It is chosen for a particular patient when its advantages in precision and recovery outweigh the alternatives, and when open surgery is not specifically required by the situation.

The operation is performed under general anaesthesia, so the patient is fully asleep. The surgeon makes a few small incisions, usually around one centimetre, through which a camera and the robotic instruments are placed; gentle carbon dioxide gas creates a working space inside the abdomen or pelvis. Seated at the console, the surgeon views the magnified three-dimensional image and controls the instrument arms, whose movements are filtered of any tremor and scaled for fine precision, while a surgical team remains at the patient's side throughout. The wristed instruments allow cutting, dissecting and stitching at angles that are difficult with straight keyhole tools, which is especially valuable for reconstruction and nerve-sparing work. At the end the instruments are removed and the small incisions are closed. Depending on the operation, the procedure usually takes about 1.5 to 4 hours.

A good candidate is generally someone who is suitable for keyhole surgery and fit for a general anaesthetic. Suitability depends on the specific condition, previous operations and overall health, and is confirmed after examination, imaging and any tests the operation requires, such as staging scans for cancer. Routine blood tests and a heart trace where appropriate confirm fitness for anaesthesia. Smoking is best stopped beforehand, and blood-thinning medicines are paused on medical advice. There are situations where open surgery remains the better choice, such as very large tumours, certain emergencies, or extensive scarring from previous surgery, and the team will say so honestly. For international patients, scans and reports can be reviewed remotely before travel, so the plan is confirmed quickly on arrival.

Because the wounds are small, recovery is usually quicker and more comfortable than after open surgery. Most patients are encouraged to walk the same day or the next, and the hospital stay is commonly one to three nights depending on the operation. Light activity resumes within days and desk work within two to four weeks, while heavy lifting and strenuous exercise are avoided for several weeks while healing completes. Planning a trip abroad, it is sensible to stay in the destination city for about 7 to 10 days so that early healing can be checked and, after cancer surgery, the first results discussed before flying. Air travel is comfortable once the surgeon confirms recovery is on track. Follow-up then continues remotely by message or video, with interpreter support, and any longer-term monitoring such as cancer follow-up can be arranged near your home.

Robotic surgery is well established and safe in trained hands, and shares the general risks of any operation under anaesthesia, including bleeding, infection and the small risks of anaesthesia itself. Specific to keyhole and robotic surgery, there is an uncommon chance that the operation needs to be converted to open surgery if it cannot be completed safely through small incisions; this is a sensible safety decision, not a complication. Compared with open surgery, robotic procedures generally mean less blood loss, fewer wound problems, less pain and a shorter recovery, while achieving the same or better disease control. Compared with standard keyhole surgery, the three-dimensional view, steadier instruments and greater range of motion support more precise dissection and reconstruction, which is particularly valuable for nerve-sparing and cancer operations in confined spaces.