Robotic surgery during the COVID pandemic: why now and why for the future

Abstract

Health care has changed in unprecedented ways since the first reported cases of COVID-19. With global case rates continuing to rise and government restrictions beginning to loosen, many worry that a second wave in our future. In many hospitals around the world, non-emergent surgeries were put on hold as hospitals were transformed into COVID centers. As surgeons and administrators do their best to reinstate non-emergent procedures, guidance is sought from any and all reliable sources. Robotic surgery has many known and demonstrated benefits over open surgery and often over conventional laparoscopy. In this commentary, we aim to highlight some of the advantages robotic surgery may offer during this uniquely challenging time in health care.

COVID-19 and Gynecological Cancers: A Summary of International Recommendations

“…With robotic surgery, the surgeon's console is separated from the robot, providing more space between team members. Additionally, robotic surgery may require fewer assistants, which means less overall exposure [6].…”

“…For patients with early-stage cervical cancer (FIGO IA, IB1, IB2, and IIa stages), if surgery is still allowed in the institution, consider standard treatment with surgery. However, when access to surgery is limited, the following procedures may be considered [3][4][5][6]8 For locally advanced stages of the disease (FIGO stages IB3, IB2-IVA), concurrent chemoradiotherapy followed by brachytherapy is recommended and should be started on time without delay [7,8]. Consider hypo-fractionated radiotherapy to reduce the frequency of patient exposure to treatment stations [4].…”

A commentary on “Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1″

“…From re-organising entire surgical teams and repurposing theatres to educating clinicians on PPE and COVID-19 management, every effort has been made to minimise transmission whilst maintaining the best possible standard of care. We propose that the current situation has demonstrated a demand for robotic and remote surgery as it enables elective procedures to be carried out with a decreased risk of contamination and transmission of the virus [ 2 ].…”

“…One obvious benefit of robot-assisted procedures is the need for fewer staff members in the operating theatre thus, decreasing the chances of bodily fluid contamination and subsequent viral transmission [ 2 ]. Moreover, by having less staff in theatre, not only is the use of PPE (that is required to treat COVID-19 patients) minimised, but those staff members can be instead redirected to COVID response teams.…”

“…Moreover, by having less staff in theatre, not only is the use of PPE (that is required to treat COVID-19 patients) minimised, but those staff members can be instead redirected to COVID response teams. Additionally, it is recognised that robotic surgery is associated with a decreased risk of overnight admission in comparison to more traditional laparoscopic surgery [ 2 ]. Prolonged hospital admission places patients at an unnecessarily high risk of viral transmission and therefore surgeons must take steps to minimise time spent recovering in hospital.…”