HJAR Jul/Aug 2023

54 JUL / AUG 2023 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN ONCOLOGY ROBOTIC TECHNOLOGY has radically changed the surgical landscape. In the last five to 10 years, robotic surgery has brought about dramatic improvements in patient experiences and outcomes and even rede- fined what it means to be a surgeon. With robots, we have extreme access and accu- racy. We get magnified, high-definition views. We can keep muscles and ligaments intact. The changes are overwhelmingly positive — procedures are far less invasive, resulting in reduced risk, less pain, faster recovery, and other benefits. But robotic surgery has also brought about emerging issues that we’ll have to navigate together. Endless application It started with urology. The surgical pro- cedure for prostate cancer, a radical prosta- tectomy, used to be an unbelievably difficult surgery fraught with complications, includ- ing massive blood loss. We went from all- open surgery to laparoscopic, which was a big step, but it was still difficult to get to the prostate. The robot, with its very thin articu- lating arms, changes everything in terms of accessibility, not to mention the incredible 3D visualization. For starters, it holds everything precisely and perfectly without moving. With laparos- copy, we must rely on a person who might get tired or have a little tremor. We can nev- er guarantee perfect stillness with a person, but a robot? It’s a game changer. With this technology, we can control the blood ves- sels, spare the nerves, make sure the ureter is good, and somuchmore. Robotic technology takes a high-risk, high-morbidity operation and turns it into an overnight stay. And there are so many opportunities to make many other procedures better. In my world, head and neck, we now have transoral robotic surgery (TORS) thanks to modified robot arms that have a special de- vice to open the mouth wide, allowing ac- cess to the base of the tongue, voice box, and The Monumental Advancements and Unintended Consequences of Robotic Surgery