Why Robotic Surgery?

Abstract

Since the initial robotic-assisted laparoscopic prostatectomy in 2000, robotic-assisted surgery has become deeply ingrained in urology. The minimally invasive nature of robotic surgery has been shown to improve patient postoperative pain and decrease length of stay. Patient outcomes in conjunction with ergonomic and visualization benefits for surgeons lead to widespread adoption. Urologic oncologists enthusiastically incorporated the robotic platform in their common abdominal cases. First, it was adopted in the radical prostatectomy followed by radical nephrectomy and finally cystoprostatectomy. Urinary tract reconstruction was primarily limited to repair of ureteropelvic junction obstruction and ureteroneocystostomy until the recent past. Reconstructive urologists are increasingly adopting the robotic platform to address a wide variety of complex upper and lower urinary tract pathologies. In the last 10 years, initial descriptions of robotic-assisted buccal ureteroplasty, vesicourethral anastomotic stricture repair, vesicorectal and vesicovaginal fistula repair, and ureteroenteric stricture revision have been described. The patient benefits of minimally invasive robotic surgery in conjunction with improved surgeon ergonomics and visualization will likely expand the role and penetrance of robotics in reconstructive urology in the years to come.