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Robotic Systems and
Infertility Surgery
Chapter 36
Brielle A. Marks, BA and
Larry I. Barmat, MD❍ How do robotic surgeries differ from laparoscopic surgeries?
Laparoscopies use a two-dimensional camera which projects an image on monitors that are in the operating room,
the operation is done using instrumentation held by the surgeon, and the surgeon is at the bedside. Robotic
surgeries use a three-dimensional camera and the surgeon is looking at the patient through the surgeon’s console
controlling the instruments using the robot.
❍ What are the advantages of robotic surgery over traditional open surgeries and laparoscopic surgeries?
Open surgeries require a larger incision that results in increased scarring, longer inpatient stay, and increased
morbidity. Laparoscopic surgeries have a lower presence of adhesions, decreased postoperative pain, decreased
length of inpatient stay, quicker recovery time and return to normal activity, less scarring, and decreased blood
loss. Robotic surgeries have a significant decrease in blood loss, decrease in complication rates, decreased length
in inpatient stay, lower risk of infections, three-dimensional view, comfortable positioning of the surgeon in the
surgeon’s console, and wrist-like motion of the robotic arm; field of view is similar to the laparotomy, but the
procedures were significantly longer than laparoscopies.
❍ What are the advantages of the Da Vinci robotic system?
Three-dimensional vision, tremor filtration, immersive environment, motion-scaling, intra-abdominal articulation
with most instruments, suturing, and tying of knots. For the surgeon, less fatigue, tremors, and frustration. For the
patient, less inpatient hospital time, blood loss, and scarring.
❍ What are the disadvantages of the Da Vinci system?
Lack of haptic feedback, bulky robotic arms (can lead to frequent collisions), limited instrumentation, inability to
move the surgical table once the robotic arms are in place, difficulty for the surgical assistants to maneuver around
the patient, and very costly (initial start-up for the system is approximately $1.5–2 million and each instrument is
approximately $2,000 for 10 uses.), larger ports for robotic surgery.
❍ What are some improvements that can be made for the Da Vinci system?
Haptic feedback, decrease the size of the surgical cart, cost, and the number of incisions.