Robotic surgery at the Clínica
The Clínica Universidad de Navarra is always at the forefront in new systems for diagnosis and therapy, and since 2010 this equipment has included the robot Da Vinci® used to carry out less invasive operations.
The main advantages that this machine brings to the surgeons using this advanced equipment are greater surgical precision, less invasive procedures, the elimination of the natural tremor of the surgeon's hand and a better field of vision.
The professional team required to carry out robotic surgery is similar to that of a laparoscopic operation. Generally, it involves two surgeons, three nurses (including one who specialises in anesthesia) and an anesthetist.
This equipment is not only used for radical prostectomy operations in the surgical treatment of prostate cancer, specialists at the Clínica have also been the first to use the Da Vinci® robot to treat obstructive sleep apnoea syndrome (OSA).
Additionally, they have been the first Spanish surgeons to operate on throat cancer with this system and carry out robotic surgery on the thyroid through the armpit, avoiding a scar on the neck.
Other medical specialties that could benefit from surgery via the Da Vinci® robot are: Urology, certain diseases in Gineacology, General surgery, Cardio-Thoracic surgery, Pediatric surgery, Otorhinolaryngology and some incidences in Neurosurgery.
Robotic surgery overcomes the limitations of conventional laparoscopic surgery as the operations are more comfortable and precise, above all for the most complex and inaccessible areas, for example in radical prostectomies.
The Da Vinci® surgical robot is a computer controlled robotic system that increases the surgeon's ability to operate in a less invasive way.
It brings with it a greater surgical precision, a less invasive procedure, the elimination of the natural tremor the surgeon's hands and a better field of vision on which is being operated.
The equipment is designed to enable seven degrees of freedom of movement, practically the same as the mobility of the surgeon's hands, unlike conventional laparoscopic surgery, which allows for only four degrees.
The loss of blood during the operation and need for transfusions stands at around 25% below the need in open surgery, a similar percentage to laparoscopic surgery.
Radical prostatectomy (aiming at removing prostate tumours) is the most frequently carried out operation for this system. However, it is also used in Urology for parcial nephrectomy, ureteral reimplantation and pyeloplasty.
The advantages when compared with conventional techniques include recuperation of bladder control within the first three months which is much quicker than with laparoscopic or open surgery due to better precision in tissue dissection.
Another of the most frequent complications in patients undergoing a prostectomy is sexual impotence. With robotic surgery, we are able to preserve the patients ́iliotibial band or erector nerves in a larger number of patients. This allows for a more effective conservation of sexual potency and better physical integrity of the sphincter muscle in the urethra, thanks to a more finely tuned and anatomic dissection.
The stay in hospital required for a robotic radical prostectomy operation, is similar to that of laparoscopic surgery, however the stay is between 2 to 3 days rather than the 5 day stay for conventional surgery. The operation with the Da Vinci® system lasts around 4 to 5 hours, and a general anesthetic is always used.
We are pioneers in thyroid disorder surgery, OSA and throat cancer with the Da Vinci® robot.
Transoral robotic surgery is carried out with specially designed instruments which are reduced in size and with more precise handling. They allow the surgeon to work with perfect visualisation, to the exact millimeter.
Robot surgery is used to extract tonsil tumors at the base of the tongue, hypopharynx and the voice box, as an alternative to surgery with a laser or to the open surgery procedures conventionally used for thyroid disorders.
Thanks to the technology of the Da Vinci® robot, we are able to extract a wider variety of tumours and it is frequently carried out in a single operation, compared with the dissection of fragments of tumours carried out using other surgical methods.
This surgery offers the patient a new alternative for surgical treatment, with a quick healing process and functional recovery, as well as good results from the treatment.
The Clínica is the first hospital in Spain that has operated on thyroid disorders with this robotic technique. The main benefit is aesthetic, in that it avoids a cervical scar from the conventional thyroid surgery by making only one incision in the armpit.
The transaxillary robotic technique is the best option for removing the nodular goiter, thyroid follicular carcinomas which are no larger than 2cm, without the extracapsular extension and parathyroid gland adenomas (hyperparathyroidism).
The Clínica is a pioneering expert in Spain for the surgical treatment of other diseases with robotic surgery: obstructive sleep apnea syndrome, partially removing the tonsil through the oral cavity (transoral), and transoral larynx cancer.
Radical prostectomy (aiming to remove prostate tumours) is the most frequent operation of all the procedures this system carries out.
Equally, it operates on problems relating to obstructive sleep apnea syndrome and the thyroid disorders.
Other diseases that can also take advantage of this technique are pyeloplasty, ureteral reimplantation, nephrectomy, partial nephrectomy, nephrectomy in a living donor, radical cystectomy (aided by a mini-laparotomy) and the reconstruction of the pelvic floor muscles.
In gynaecology, the technique is applied in hysterectomy, tubal reconstructions, myomectomy and uterus tumours.
The Da Vinci® robot is used in different diseases in General Surgery including colon and rectal surgery, gastric bypass surgery, hepatobilio-pancreatic and surgeries in the lower third of the oesophagus.
As for cardiothoracic surgery, robotic surgery is used in coronary aorto bypass operations, mitral valve repair, atrial septal defect, tricuspid valve repair and mediastinum and lung surgery.
Likewise, it is used in some pediatric and neurosurgery operations.