Robotic Surgery in Urology

Minimally invasive surgery has come of age. Now well into its second decade of use in urologic surgery; we are embarking on the next leap into the future, 'Robotic Assisted Surgery', the term universally applied for that of remote computer-assisted telemanipulated surgery. Indeed, in the early 1990s the introduction of laparoscopic surgery for staging pelvic lymphadenectomy in prostate cancer and the performance of nephrectomy, opened the doors to the field of laparoscopic surgery in urology. Early attempts at more complex reconstructive operations requiring suturing techniques, such as radical prostatectomy, bladder surgery and upper tract procedures were either abandoned, performed by a few highly skilled individuals or relegated as possible but impractical for most surgeons. The arrival and safe introduction of the robot in the operating theater is without doubt the most important technological development in surgery at the present time: it allows the performance of surgical procedures in a minimally invasive fashion yet mimicking open surgery almost identically, thus shortening the learning curve and more importantly permitting surgeons adept at radical surgery to transfer their skills directly in a minimally invasive way to the patient. This is an evolving technology still in its infancy with many answers still forthcoming. This text offers the surgeon a practical guide to the most common robotic assisted procedures performed today, concisely explaining the nuances of establishing a successful robotic program and how to care for patients before, during and after robotic surgery.