Minimally invasive and robotic surgery Despite the
widespread acceptance of laparoscopic techniques
for benign conditions, the role of laparoscopy
in cancer management remains under debate.
Laparoscopy for the staging of malignant disease
is routine in some tumour sites, such as upper gastrointestinal malignancies. However, acceptance
of laparoscopic resection of solid tumours has
been hindered by fears such as maintenance of the
integrity of the oncological resection, for example
resection margins and lymph node harvest, and
the potential for a negative effect on survival, for
example port site metastasis (Hagiike and Lefor
2008). Despite these fears, studies in the past decade
have confirmed the feasibility and safety of the
laparoscopic approach, which has now expanded
to the treatment of gastrointestinal, pancreatic
and hepatobiliary, urological and gynaecological
malignancies (Tausch and Tschmelitsch 2006).
The use of robotic technology in medical
applications has shown great potential since its
initial introduction into the operating theatre during
the 1980s (Novakovic and Pinto 2008). The rapid
evolution in technology has shown great potential
in expanding the surgeon’s natural proficiency
(Desai and Gullapalli 2009). For example, use of
robotic devices for automation of laparoscopic-based
interventions, as described by Ramirez (2009),
affords patients the same benefits of laparoscopy
while undergoing procedures that require advanced
surgical skills and precision.
The use of surgical robots involves a surgical
console that is positioned remotely from the
patient with a computer system and controls
that manipulate the robotic arms. This allows the
movements of the surgeon to be converted into
robotic movements that imitate open surgery
(Novakovic and Pinto 2008). A three-dimensional
endoscopic view is provided on a screen, and the
articulation of the instruments emulates the motion
of the human wrist