LAPAROSCOPIC AND ROBOTIC SURGERY
Laparoscopy, initially used only for diagnostic purposes, nowadays it becomes a treatment method. In comparison to conventional, open surgery, laparoscopic interventions have more benefits due to less postoperative pain and a reduced stay in hospital, as well as faster recovery and low mortality rate.
There is no doubt that the surgeon’s experience and the proper selection of patients are the most important factors of the success in the field of laparoscopic surgery.
Other important factor is equipment that is used during operation and its quality. Smaller and less traumatic instruments developed in recent years, new generation coagulation devices, improved imaging quality have led to more successful implementation of laparoscopic surgery. The imaging system of laparoscopic surgery, provide same view for surgeon and for other viewers of procedure. It is both an advantage and a serious disadvantage. The possibility of a wide visualization during training may encourage some surgeons to conduct laparoscopic surgery without completion of the necessary stages of training and sufficient experience. This ease of visualization conversely increases complications of laparoscopic surgery, which requires long training. Compared with open surgery, correction of complications of laparoscopic procedures are much more difficult. For this reason as much as advanced level, it is necessary to carefully go through the basal level training. Laparoscopy requires the cooperation of the team. As well as the surgeon, his assistant, nurses, and anesthetic team should be experienced and well educated in area of laparoscopic surgery. Because of that, laparoscopic surgical clinics in the early stages should trained their team in other more experienced centers. Next important step, especially in the beginning, is the right choice of, partly more simple, cases. Selection of patients is a stage which should be considered to gain experience and develop self-confidence of the surgeon. Adequate and sufficient preparation of the surgical team and choice of patients are as important as selection of quality and useful tools and imaging systems.
Robotic surgery is in terms of technology the most advanced area of modern surgery. In comparison of robotic surgery with laparoscopic both advantages and disadvantages are visible.
The most significant advantage of robotic surgery is a 3D imaging. It is particular benefit in visualization of biliary tract and other tubular structures such as the esophagus or intestine. The possibilities of robots movements are much bigger. Another advantage is the ability to control the camera by a surgeon without the help of an assistant. The most significant disadvantage of robotic surgery is the lack of tactile sensations and the cost. Despite these disadvantages robotic surgery in the near future will become standard surgical treatment.