Laparoscopic vs robotic surgery: What's the difference?

November 21, 2023
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Understanding laparoscopic surgery

Traditional laparoscopic surgery goes by many other names:

  • Endoscopic surgery
  • Keyhole surgery
  • Arthroscopic surgery
  • Thoracoscopic surgery

The surgical procedure involves using a narrow camera, called a laparoscope, to look within the body. Very small incisions are made at the point of entry - about 0.2 inches - and the camera and instruments are inserted through these minor cuts.

It is commonly used for surgeries within the abdomen; however, it has become more common in urology and even cancer surgery.

The surgeon never physically places their hands inside the body in laparoscopic surgery. Instead, they use the visuals from the camera to complete complex procedures.

Common laparoscopic procedures include:

  • Biopsies
  • Removing small tumors, cysts, or polyps
  • Tubal ligation
  • Removing the appendix
  • Hernia repair
  • Gynecological procedures

Advancements in robotic surgery

Robotic surgery is much more advanced than traditional laparoscopic surgery.

The most widely adopted Surgical robot is Intuitive Surgical's da Vinci Surgical system, which has been used millions of times since its invention in 2000.

Robotic surgery is similar to laparoscopic procedures in the sense that tiny incisions and high-resolution cameras are used. However, these surgical procedures are much more advanced because mechanical or robotic arms are used by the surgeon to perform the procedure.

As technology advances and artificial intelligence (AI) develops, robotic surgeries are starting to integrate machine learning and AI to perform complex procedures. It is expected that robotic surgery will become the standard of care for many surgeries and will become more affordable and less traumatic for patients.

Common robotic surgery procedures include:

  • Prostatectomy
  • Hysterectomy
  • Kidney removal
  • Hip replacement
  • Mitral valve repair
  • Coronary artery bypass surgery
  • Gallbladder removal
  • Pyeloplasty

Comparing surgical techniques

There are clear similarities between the two different types of surgery - each being a minimally invasive surgery procedure. However, there are also major differences.

With robotic surgery, the surgeon isn't physically near the patient's body. Instead, the surgeon is sitting in a console within the operating theater. From here, the robotic instruments are controlled. There is still an entire medical team with the patient to ensure the procedure runs smoothly.

With laparoscopic surgery, the surgeon has the instruments in his hands and is scrubbed in. The surgery is then performed using the instruments through small cuts and with the aid of a camera. This often offers the surgeon greater dexterity; however, it does have its limitations.

Despite the differences between the two surgical procedures, both have major advantages compared to traditional open surgery.

Pros and cons of laparoscopic surgery

Below we discuss the advantages and limitations of laparoscopic procedures:

Pros

  • Improves recovery and reduces post-operative pain
  • Shorter hospital stay
  • Less risk of injury during the operation
  • Reduced use of anesthetics
  • Reduced risk of infection
  • Less blood loss
  • Less pain and discomfort following the procedure
  • Smaller scars
  • Patients can return to normal daily life much faster

Cons

  • Two-dimensional imaging
  • Surgeons may struggle to reach the required areas
  • Very expensive procedure
  • Not suitable for very complex surgeries
  • Laparoscopic and open surgery can go hand-in-hand, as open surgery may be required if complications arise.

Benefits of robotic surgery

Robotic surgery is still in its infancy and is expected to continue to develop as new technologies emerge. It already holds a lot of benefits over conventional laparoscopic and open surgery, including:

  • Improved range of motion for the surgeon
  • Accuracy and speed
  • Incredible precision due to multi-jointed robots
  • More affordable than general open surgery and conventional laparoscopic surgery
  • Reduced postoperative complications
  • Three-dimensional camera with depth perception
  • Improved ergonomics for the surgeon
  • Great range of motion using minimally invasive techniques

Making an informed surgical decision

Before undergoing any surgical procedure - including minimally invasive procedures - it is important that patients make informed decisions. Surgeons must also consider certain factors to ensure the proper procedure is undertaken.

Below are some considerations that must be kept in mind when considering either a laparoscopy or robotic surgery:

  • The risks and benefits of each procedure must be discussed with the surgical team. Traditional open surgery may be more affordable, but robotic-assisted laparoscopic surgery achieves faster recovery times and less aesthetic damage.
  • Patients must consider their insurance coverage. Robotic procedures may not be covered fully by health insurance. The insurance policy may determine which procedure is selected.
  • The health and needs of the patient may also influence the type of surgical procedure. Surgery must be tailored to individual patients, and consideration given to their medical history, lifestyle, age, and work requirements.
  • The expertise of the surgeon and medical staff can influence the procedure. With robotic-assisted surgery still relatively novel (compared to traditional open surgery), not all hospitals or surgeons may offer these procedures.

Patients must be willing to ask questions and communicate openly with their medical team. It is crucial that a patient understands all aspects of the recommended procedure before consenting.

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Choosing the right surgical approach

Typically, laparoscopic procedures are used for surgery in the abdominal and pelvic areas.

Robotic surgery uses more advanced technology, so can be used for more complex surgeries throughout the body, as mentioned earlier in this article. It can be adopted across different surgical specialties and isn't limited to the abdomen.

When it comes to choosing the right surgical approach, the following will be considered:

  • The complexity of the surgery
  • The patient's anatomy
  • The skill set of the surgeon
  • The overall health of the patient

The choice between laparoscopic and robotic surgery should be an open discussion between the patient and their medical team so that the correct procedure is undertaken.

Exploring laparoscopic vs. robotic surgery

The biggest difference between laparoscopic and robotic surgery is the instruments used to perform the procedures.

Laparoscopic surgery is performed through small "keyholes" through the abdominal muscles. A handheld camera, called a laparoscope, is used and the surgeon uses the laparoscope and surgical instruments to perform the procedure.

Robotic surgery also makes use of small incisions; however, robotic arms are used to manipulate the surgical instruments. The surgeon controls the robotic arms from within a console in the operating room.

Where laparoscopic operations are used mainly in the abdomen and pelvis, robotic surgery has vast applications. It can be used in cardiac surgery, liver transplants, prostate procedures, and even brain surgery. The main benefit of robotic-assisted procedures over more traditional surgeries is the precision and speed with which the surgery can be done.

FAQs

How do laparoscopic and robotic surgeries compare in terms of recovery time?

Both surgeries have shorter recovery times compared to open surgery because of the small incisions and reduced internal trauma. Depending on the type of surgery, the recovery times are quite similar. However, the risk of complications with laparoscopic or keyhole procedures is greater, which may require a second surgery.

Are there specific medical conditions where laparoscopic surgery is preferred over robotic surgery?

Laparoscopic procedures are preferred for abdominal and pelvic operations. Robotic surgery is preferred for more complex operations in a variety of surgical specialties. However, the patient's medical history and the surgeon's skills will also determine which minimally invasive surgery is preferred.

What advancements in artificial intelligence and machine learning are being integrated into robotic surgery?

Robotic surgery has been incorporating AI and machine learning to enhance precision. It can also help in on-the-spot decision-making through real-time data analysis and predictive analytics.

Wrapping up

Open and laparoscopic surgery has been the standard surgical technique for many years. However, with the advancement in medical robotics, robotic surgery is becoming a much more viable and affordable option.

The laparoscopic approach may be a minimally invasive surgery, but robotic surgery offers many more advantages. As technology continues to be refined and more complex robotic systems are developed, robotic procedures will be used for more complex operations in the future.

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