Purpose and Clinical Use

Learn Robotic Surgery fundamentals, types, and core definitions explained by multidisciplinary Robotic Surgery teams.

Purpose and Clinical Use: A New Standard of Care

Robotic surgery was once considered a futuristic novelty, reserved only for the most experimental cases. Today, it has become the Standard of Care for many complex procedures across multiple medical specialties.

At Liv Hospital, we do not use robots simply because they are “new.” We use them because clinical evidence proves they offer superior outcomes for specific conditions. Whether it is sparing the microscopic nerves responsible for sexual function during prostate surgery or aligning a knee replacement with sub-millimeter accuracy, the robot allows our surgeons to perform tasks that are physically impossible with the human hand alone.

This page outlines the specific diseases and conditions we treat using our fleet of robotic systems (Da Vinci Xi, Mako, Mazor), explaining exactly why the robotic approach is preferred over traditional open surgery.

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Urology: The Pioneer of Precision

Urology is the field where robotic surgery first proved its worth. The pelvis is a deep, narrow, and dark space filled with critical veins and nerves. The robot’s 3D vision and wristed instruments turn this difficult anatomy into an accessible surgical field.

Robotic Radical Prostatectomy

This is the Gold Standard treatment for localized prostate cancer.

The Challenge: The prostate gland sits deep in the pelvis, sandwiched between the bladder and the rectum. Wrapped around it are the “Cavernous Nerves” that control erections.
The Robotic Solution: The Da Vinci robot provides 10x magnification. The surgeon can see the nerves as distinct white fibers. Using tiny wristed scissors, we can peel the prostate away from these nerves millimeter by millimeter (Nerve-Sparing Technique).
The Benefit: Higher rates of cancer cure (negative margins) combined with significantly faster return of urinary control (continence) and sexual function compared to open surgery.

Robotic Partial Nephrectomy

The Challenge: Removing a tumor from a kidney while leaving the healthy part of the organ intact. The kidney is highly vascular; cutting it risks massive bleeding.

The Robotic Solution: The robot allows the surgeon to clamp the blood vessels, cut out the tumor, and sew the kidney back together in record time (Warm Ischemia Time).

The Benefit: The patient keeps their kidney function, avoiding dialysis, while being cured of cancer.

Gynecology: Fertility and Aesthetics

For women requiring pelvic surgery, the robot offers a cosmetic advantage (tiny scars) and a functional advantage (fertility preservation).

Robotic Myomectomy (Fibroid Removal)

The Purpose: Removing uterine fibroids that cause pain or heavy bleeding in women who want to have children in the future.
The Robotic Advantage: Unlike standard laparoscopy, the robot allows for multi-layer suturing (sewing). This creates a stronger uterine wall repair, which is critical to prevent rupture during a future pregnancy.

Robotic Hysterectomy

The Purpose: Removing the uterus for cancer (Endometrial/Cervical) or benign conditions (Adenomyosis/Prolapse).
The Robotic Advantage: For obese patients or those with large uteruses, open surgery used to be the only option. The robot’s powerful arms can lift and manipulate heavy tissue effortlessly, allowing these difficult cases to be done through keyhole incisions. Hospital stay is reduced from 3–4 days to 24 hours.

Deep Infiltrating Endometriosis

The Purpose: Removing endometriosis tissue that has glued organs together (frozen pelvis).
The Robotic Advantage: The precision allows us to dissect the endometriosis off the bowel, bladder, and ureters without damaging these vital organs.

General Surgery: Abdominal Complexities

General surgeons use the robot for procedures involving the gut, stomach, and abdominal wall.

Robotic Colorectal Surgery

The Purpose: Removing cancers of the rectum or colon (Low Anterior Resection).
The Robotic Advantage: Working deep in the narrow pelvis to reconnect the bowel (anastomosis) is difficult. The robot’s 360-degree articulation ensures a secure connection, reducing the risk of leaks and the need for a permanent colostomy bag.

Robotic Hernia Repair

The Purpose: Fixing inguinal (groin) or ventral (abdominal wall) hernias.
The Robotic Advantage: We can place the mesh behind the muscle (Retro-Muscular Repair) rather than just patching over the hole. This is mechanically stronger and has a lower recurrence rate. Suturing the mesh to the abdominal roof is tedious laparoscopically but easy robotically.

Robotic Bariatric Surgery

The Purpose: Gastric Bypass or Sleeve Gastrectomy for weight loss.
The Robotic Advantage: In patients with very high BMI (>50), the abdominal wall is thick. Standard laparoscopic instruments can bend or struggle against this pressure. The robotic arms are rigid and powerful, providing a stable platform regardless of patient size.

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Orthopedics: The Mako Revolution

While Da Vinci focuses on soft tissue, the Mako Robotic-Arm is designed for hard bone. It transformed joint replacement from “eyeball carpentry” to digital engineering.

Robotic Total Knee Replacement

The Challenge: Every knee is unique. Standard instruments use “average” cutting blocks that don’t fit everyone perfectly, leading to pain or stiffness.
The Robotic Solution: Before surgery, a CT scan creates a 3D model of your knee. During surgery, the robot guides the surgeon to cut the bone exactly as planned to balance the ligaments.
The Benefit: Less pain, less need for physiotherapy, and a more “natural-feeling” knee.

Robotic Partial Knee Replacement

The Challenge: Replacing only the damaged compartment (medial or lateral) while saving the healthy bone and ACL ligament.
The Robotic Solution: The robot ensures the implant is placed so precisely that it tracks perfectly with the native bone. This surgery is rarely done manually because it is so hard to get right; with Mako, it is routine.

Robotic Total Hip Replacement

The Challenge: Placing the cup (socket) at the correct angle to prevent dislocation and leg length discrepancy.
The Robotic Solution: The robot guides the reaming of the hip socket to the exact degree required. It prevents the surgeon from removing too much bone.

Thoracic Surgery: Breathing Easier

Surgeons operate on the lungs and thymus gland through the spaces between the ribs.

Robotic Lobectomy: Removing a lobe of the lung for cancer. The robot’s wristed instruments allow dissection around the delicate pulmonary artery and vein without needing to spread the ribs (which causes chronic pain).
Thymectomy: Removing the thymus gland for Myasthenia Gravis. The robot allows access from the side of the chest, avoiding a Sternotomy (splitting the breastbone).

Head and Neck: Transoral Robotic Surgery (TORS)

For cancers of the throat (Oropharynx) and base of tongue.

The Old Way: Splitting the jaw and lip to reach the back of the throat. This was disfiguring and required a tracheostomy (breathing tube).
The TORS Way: The robotic arms are thin enough to enter through the open mouth. The surgeon removes the tumor from the inside.
The Result: No visible scars on the face, faster swallowing recovery, and often no need for chemotherapy afterward.

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Comparative Benefits: Why Upgrade?

Why should a patient choose robotic surgery over traditional methods?

Feature	Open Surgery	Laparoscopy (Keyhole)	Robotic Surgery
Incision Size	Large (10–20cm)	Small (0.5–1cm)	Small (0.8cm)
Vision	Direct Line of Sight	2D Screen (Flat)	3D High-Definition (Depth)
Instrument Movement	Human Hand	Straight Stick (Limited)	Wristed (360° Rotation)
Tremor Control	None	None	Active Filtration
Blood Loss	High	Moderate	Very Low
Hospital Stay	4–7 Days	2–3 Days	1–2 Days
Pain Level	High	Moderate	Low

Who is NOT a Candidate?

While robotic surgery is advanced, it is not for everyone.

Multiple Previous Surgeries: If a patient has a “hostile abdomen” (frozen with scar tissue from many prior open surgeries), the robot may not have enough space to work safely.
Severe Heart/Lung Disease: Robotic surgery requires filling the abdomen with CO2 gas and tilting the patient head-down (Trendelenburg position). Some patients with severe heart failure or glaucoma cannot tolerate this pressure.
Very Large Tumors: If a tumor is larger than the pelvic opening, it may require an open incision to be removed intact without rupturing.

Liv Hospital: A Center of Excellence

At Liv Hospital, robotic surgery is not an occasional event; it is our daily routine.

Dedicated Teams: We have nursing teams and anesthesiologists who specialize only in robotic cases. They know the equipment and the protocols inside out.
Dual Console Training: Our systems have two consoles, allowing two expert surgeons to collaborate on difficult cases simultaneously.
Global Patient Flow: We routinely treat international patients who seek robotic options that may not be available or affordable in their home countries.

FREQUENTLY ASKED QUESTIONS

Can robotic surgery treat Stage 4 cancer?

Robotic surgery is a local treatment. It removes the primary tumor. In Stage 4 (metastatic) cancer, surgery is usually palliative (to relieve symptoms) rather than curative. However, we often use the robot to remove the primary tumor to prevent blockage or bleeding, while systemic chemotherapy treats the spread.

Is Mako surgery faster than manual knee replacement?

The surgery itself takes about the same time (60–90 minutes). The planning (CT scan) takes extra time before surgery. However, the recovery is significantly faster because there is less damage to the soft tissues around the knee.

Will I have scars after robotic surgery?

Yes, but they are very small. You will typically have 4 to 6 small incisions (about 8mm–12mm long) scattered across the abdomen. These usually fade to invisible white lines within a year. In “Single-Port” robotic surgery (available for some cases), there is only one scar hidden in the belly button.

Does insurance cover robotic surgery?

Most private international insurance plans cover robotic surgery if it is deemed “medically necessary” (e.g., for cancer). Some policies may classify it as a “premium” service. Our International Patient Coordinators will check your specific policy coverage for you.

Can the robot remove large fibroids?

Yes. The robot is excellent for large fibroids because of its strength and suturing ability. We remove the fibroid from the uterus, put it in a bag inside the abdomen, and cut it into smaller strips (morcellation) to pull it out through the small keyhole incision.

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Purpose and Clinical Use