1. What advantages does robotic surgery offer the specialist?
Dr. Charo Noguero (CN): Provides a greater ergonomics versus surgery laparoscopic traditional. It also reduces the time surgical in front of this and also in front of the open one.
Dr. Ignacio Muguruza (IM): It also offers greater security thanks to an immersive three-dimensional vision with a very high degree of detail of the structures. The surgeon feels more confident and suffers less physical fatigue.
2. And for the patients?
(CN): The size of the incisions is clearly lower, which results in a postoperative better and shorter, less pain, less chance of complications and a faster incorporation into daily life. He Da Vinci robotic system It is the most advanced technology available to perform minimally invasive surgeries and it is revolutionizing the hospital sector. More than 70 centers in Spain already have this help.
3. The robotic surgery program at the Rey Juan Carlos University Hospital (HURJC) has just turned 10 years old. What technology does it use?
(CN): The Xi Da Vinci system, the latest platform update implemented at the start.
(IM): This model is ideal for shared use by different specialties.
4. How many surgeries have been performed since its implantation?
(MI): After a decade, we are approaching 2,000 interventions.
5. In what services has it been launched?
(CN): In General Surgery and Digestive, Thoracic, Urology, Otolaryngology and Gynecology.
6. What characteristics must a service have to use this robotic platform?
(CN): You must have a sufficient number of cases that can benefit from this technology, as well as staff with the training that its use requires.
(IM): This training represents a challenge for surgeons and should be a common objective for their professional development. Coordinated work with other surgical services and Nursing is essential to obtain the highest profitability of the system. At this point, the role of the Robotic Surgery Commission, a body coordinated by the Hospital Management which includes the representatives of the surgical, nursing and teaching teams. Distributes the time of use of the robot, coordinates the different teams, decides on surgical indications and controls morbidity as well as the results obtained. In addition, it monitors the experience of patients and organizes specific teaching. All this makes it possible to optimize this surgical discipline and guarantee its accessibility, both to staff and patients, in addition to establishing quality standards.
7. Specifically, what does it contribute to Thoracic Surgery?
(IM): Facilitates safe lung resections and minimally invasive higher quality and precision while optimizing the tissue preservation. It also favors the realization of lymphadenectomies more complete. Complications are less frequent, especially the reduction of bleeding. This translates into an improvement in the quality of life of patients after surgery, with a faster recovery. Also in tumors and other benign processes of the mediastinumallows the surgeon access, through very small incisions, to areas that previously required aggressive approaches and they caused more postoperative pain and complications. It even makes it possible, in many cases, for the patient to be discharged only a few hours later.
8. And in gynecological interventions, what does it mean?
(CN): The use of robot in cases of endometriosis reduces pain, postoperative time and leaves an imperceptible scar. With Da Vinci, it also allows hysterectomies to be performed in previously discarded cases. On the other hand, it has made it possible to remove large fibroids and preserve the uterus. In surgeries of pelvic floor reduces the possibility of relapse and allows preserving the sexual function of the patient. In general, it is less traumatic to the abdominal wall. As for oncological surgery, it transforms previously very aggressive interventions into faster surgeries and with lower morbidity.
9. Are there enough qualified professionals and technicians?
(IM): The number is constantly growing. There are specific certification processes, although they are still in an initial phase. The future generalization of surgical robots poses a challenge for institutions, which must undertake the planning of these training processes in a much broader way. The role of residents is increasingly important and their specific training is essential. The coordination of the robotic commissions and the teachers is essential to achieve this objective, in which we are making great progress in our center.
10. Has Da Vinci changed the role of nursing?
(IM): Nursing’s role is essential. During surgeries, their role is essential to prepare the system, change the instruments that are attached to the robotic arms and procure an efficient use of resources to speed up procedures and optimize usage times. An experienced staff makes the team more profitable and increases the number of interventions in each operating room session.
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