Robotic Surgery

Robotic surgery at The Smith Institute is performed using The DaVinci Surgical System. The DaVinci consists of two key components: an ergonomically designed surgeon's console and the patient-side cart. The surgeon sits at the console and operates by manipulating master controls. The patient-side cart consists of four robotic arms, to which are connected a wide range of surgical instruments.

One of the great advantages of the system is that the instruments have a tremendous range of motion, using EndoWrist® instruments, which are designed with seven degrees of motion that mimic the motions of the human hand and wrist. The system essentially eliminates tremor, and maximizes dexterity, precision, and control. This is particularly advantageous in urologic oncology surgery, where fine motions are needed to delicately preserve neurovascular bundles, and reconstruct the urinary tract to ensure continence. This state-of-the-art technology allows the surgeon's hand movements to be scaled, filtered and translated in real-time into precise movements of the instruments within the patient.

Another unique aspect of robotic surgery is the InSite Vision System, which allows the surgeon at the console to see with three-dimensional (3-D) vision. The 3-D endoscope and image processing equipment provides a close-up and true-to-life view of the operative field that further assists the surgeon in delicate maneuvers such as nerve-sparing during prostatectomy and cystectomy.

Robotic surgery is performed using several small incisions, each ~1 cm in size. For most patients, robotic surgery through these small incisions offers less pain, a shorter recovery, and improved cosmesis. Robotic surgery also has the advantage of less blood loss and reduced need for blood transfusion, particularly during prostate and bladder cancer surgery. At The Smith Institute, we are striving to reduce the hospital stay, pain, and scarring associated with surgery, and offer faster recovery, quicker return to normal activities, and improved functional outcomes. With each operation we perform, our goal is to optimize the three critical and inter-related aspects of urologic oncologic surgery: cancer control, urinary function, and sexual function.