Robotic Surgery vs. Traditional Surgery: What Is the Difference?

When it comes to surgical care, innovations like robotic surgery have transformed how procedures are performed. Yet, many patients are left wondering how this modern technique compares to traditional surgery. Understanding these differences not only helps clear up misconceptions but can also empower you to make informed decisions about your care.

In this blog, we speak to Marques Peña, M.D., a general surgeon with INTEGRIS Health Medical Group General Surgery Edmond, to learn more.

“The most gratifying part of what I do is having the opportunity to offer a surgical solution to a person with a surgical need and having the privilege of witnessing the positive impact on their life,” Peña says. 

Key differences between robotic and traditional surgery

The basics: Robotic surgery is a type of minimally invasive surgery that uses advanced technology, including robotic arms and a 3D high-definition camera to perform procedures through small incisions. The benefits are reduced pain, faster recovery and minimal scarring. Traditional surgery, on the other hand, involves larger incisions to provide direct access to the surgical site, making it ideal for emergencies, complex cases or when extensive visibility and access are required.

Precision is one of the significant differences between robotic surgery and traditional surgery.

• The robotic instruments are designed to move with greater accuracy than the human hand, minimizing tissue trauma.
• With traditional surgery, the precision largely depends on the surgeon’s hand-eye coordination.
• For procedures requiring complex movements, robotic systems offer an edge.

Recovery time is reduced when using robotic surgery due to the smaller incisions.

• Traditional surgery often involves larger incisions, which means longer recovery times.
• Conversely, a minimally invasive approach accelerates healing, reduces postoperative pain and leaves less noticeable scars. 

Pain levels tend to be higher with traditional surgery because the body needs to heal from more invasive procedures.

• Meanwhile, minimally invasive robotic surgery leads to less pain post-operation because the incisions are smaller.

The scars left by robotic surgery are generally smaller and less noticeable, which can make a significant difference to patients concerned about long-term cosmetic effects.

• Open surgeries can produce scars around two to six inches for smaller procedures, but can reach six to 12 inches for major abdominal surgeries.

Hospitalization stays are typically shorter with robotic surgery.

• Open surgery frequently requires multi-day hospital stays, while robotic surgery often allows patients to go home soon after their procedure, if not the same day.

Accessibility is one of the biggest benefits of open surgery.

• While robotic surgery is evolving to become more widely available, it’s not yet standard across all health care facilities.
• Traditional surgery remains the foundational approach and is accessible in nearly all hospitals.

Benefits of robotic surgery

At a glance: Between improved technology and more accuracy, robotic surgery is becoming the preferred method for some surgeons to use over traditional methods.

A less invasive procedure is the key benefit of robotic surgery.

• Smaller incisions mean less pain, minimal scarring and a lower risk of infection.
• Many patients also recover faster and have a shorter hospital stay.

Accuracy is easier to achieve thanks to the controlled movements of robotic instruments.

• Surgeon fatigue is also reduced, as there isn’t a need for extended physical effort.

3D imaging used by the robotic system provides a magnified view of the surgical site.

• This allows surgeons to perform operations with more clarity and confidence.

How the robot works

Key points: The system includes a surgeon's console, robotic arms with specialized instruments and a high-definition 3D camera for enhanced visualization. The surgeon operates the robotic arms from the console, translating their hand movements into precise actions at the surgical site.

The robot itself contains three key components.

• The surgeon’s console features high-definition 3D cameras that provide a magnified view of the surgical site, as well as controls that translate the surgeon's hand movements into precise actions by the robotic arms.
• Several robotic arms are designed to hold specialized surgical instruments to mimic the surgeon’s movements and enable controlled actions.
• A sophisticated camera offers detailed, 3D images of the internal structures so the surgeon can see tiny anatomical details that might not be visible during traditional surgery.

To start the surgery, small incisions that are less than an inch serve as entry points for the procedure.

• Trocars and cannulas (small tubes inserted through the skin) create access points for the robotic instruments and camera.
• The robotic arms are fitted with specialized tools, such as scalpels, scissors or suturing devices.
• A 3D camera called an endoscope is also inserted to provide magnified images.

While at the console, the surgeon views 3D images of the surgical site. 

• Using hand controls and foot pedals, the surgeon directs the robotic arms to perform the desired actions.
• The system translates the surgeon’s hand movements into precise, scaled movements at the incision site.
• The flexibility of the robotic instruments allows for specialized movements, such as stitching tissues or removing damaged structures, in confined spaces.

Once complete, the surgeon retracts the robotic instruments.

• Then they close the small incisions with sutures or surgical adhesive.

The term "robotic" can be a bit misleading, as it might suggest the robot operates autonomously. 

• In reality, the surgeon is in complete control at all times, guiding the robotic instruments through a console.
• The "robot" is essentially an extension of the surgeon's hands, translating their movements into precise actions that would be difficult to achieve manually.

What can robotic surgery be used for?

What to know: Robotic surgery is not limited to a single area of medicine. Multiple surgical specialties can benefit from robotic surgery, making it a tool for addressing complex cases and routine procedures. That said, urologists, gynecologists, colorectal surgeons, cardiothoracic surgeons and general surgeons all use robotic surgeries in their practices.

Urologic robotic surgery is used for prostate removal and kidney surgeries.

• Prostatectomy involves removing the prostate gland, and robotic surgery can reduce side effects such as incontinence or impotence.
• Procedures like partial or total nephrectomy benefit from the accuracy of robotic instruments, which allow for preservation of healthy kidney tissue.

Gynecological robotic surgery is used to remove the uterus and treat women’s health problems.

• Robotic hysterectomy reduces blood loss and recovery times.
• The precise nature of the robot helps remove problematic tissues while preserving fertility when treating endometriosis or removing fibroids.

Colorectal robotic surgery is used to remove tumors or remove/repair issues in the colon and rectum.

• A colectomy involves removing all or part of the colon in cases of colon cancer, diverticulitis or inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis.
• In prolapse repair, the dexterity of robotic arms allows for the successful repositioning and securing of the rectum to restore function.
• Pelvic floor surgeries benefit from robotic assistance thanks to the control for suturing and repairing deep within the pelvic area.

Cardiac robotic surgery primarily helps perform valve repairs.

• Mitral valve repairs or other minimally invasive valve surgeries benefit from the precision in areas critical to heart function without the need for a large chest incision.

General surgeons also use the robot for hernia repairs and remove gallbladders.

• The enhanced dexterity of robotic systems improves accuracy in repairing hernias and reducing recurrence rates.
• Robotic surgery minimizes scarring and speeds recovery when removing a gallbladder (cholecystectomy).

When is traditional surgery needed?

Final thoughts: Although robotic surgery can have better outcomes, some conditions and procedures simply are best treated using the traditional open surgical approach. Examples include open-heart surgery, emergency surgery, organ transplants and abdominal surgery.

Emergencies that require immediate access don’t have time to wait for minimally invasive techniques.

• Examples include severe internal bleeding, complications from a ruptured organ and untreated infections.

Complex or extensive procedures can require direct access to a large area of the body.

• Examples include surgeries involving extensive organ reconstruction, removal of large tumors or procedures for advanced-stage cancers.

Conditions with extensive tissue or organ involvement typically need a more complex approach and benefit from open surgery. 

• For example, severe trauma from accidents causing multiple injuries to internal organs would need to be approached with an open technique.
• Organ transplants often necessitate open surgery due to the complexity of organ removal and placement.
• Large-scale hernia repairs can require open surgery where the hernia is too significant for robotic approaches.

Patient-specific factors may also make some people not candidates for robotic surgery.

• Previous surgeries that left excessive scar tissue (adhesions) can limit access, as can anatomic issues that make it difficult to navigate with robotic tools.

Next steps: Learn more about our services at INTEGRIS Health by visiting our robotic and minimally invasive surgery page.

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