Chapter 6 1 Robotic-Assisted Surgery and Related Abdominal Entry

Because laparoscopic surgery has revolutionized the concept of minimally invasive 7 surgery for the last three decades [1], new equipment, cameras, and energy sources 8 were developed that have enabled surgeons to perform more complex surgeries that 9 were once only performed by laparotomies [1]. In the field of pelvic surgery, almost 10 all types of cases now can be performed through a laparoscope, depending on the skill 11 and experience of the surgeon and the availability of proper instrumentation [1]. 12 Robotic-assisted surgery is one of the latest of the innovations in minimally invasive 13 surgery. By the twentieth century, advances in task-specific surgical instrumentations, 14 optics, and digital video equipment, as well as computer and robotic technology 15 opened a new frontier for minimally invasive laparoscopic surgery. The recent intro- 16 duction of advanced robotic devices, such as da Vinci surgical system, to the field of 17 pelvic surgery has added new hope that operative times as well as the learning curve 18 for minimally invasive surgery may be reduced. The surgeon now is able to operate, 19 suture, and dissect with the facility of the human wrist and in addition, the superior 20 three-dimensional view offered by this robotic system provides surgeons with an 21 unprecedented view of the anatomy. The three-dimensional view is a significant 22 advantage of the robotic surgical system that improves visualization and allows greater 23 precision and accuracy. Furthermore, the surgeon seated at the surgical console per- 24 forms the dissection with wristlike motions of the master controls, which provides 25 finer, more delicate manipulation of tissue and facilitates procedures that are consid- 26 ered more difficult by conventional laparoscopy. The motions of the surgeon at the 27 console unit are replicated by the robotic arms placed within the patient.