Robotic surgery in gynecologic oncology: evolution of a new surgical paradigm

Abstract

Robotic surgical platforms were first developed with telesurgery in mind. Conceptualized by NASA and the military to provide surgical expertise to remote locations; some telesurgical success has been documented; but progress has been held back by communication bandwidth limitations. Telepresence surgery; where the surgeon is in proximity to the patient but is provided with an ergonomic console equipped with three-dimensional vision and autonomous control of wristed laparoscopic surgical instruments and energy sources; has shown efficacy first in cardiac and then urologic cancer surgery. Interest is currently focused on the application of this technology in the field of gynecology; with techniques being described to perform simple hysterectomy; myomectomy; tubal anastomosis; and pelvic reconstruction procedures. This article will review the application of robotic- and computer-assisted surgery in the specialty of gynecologic oncology.