Robotic Surgery

Dear Colleagues,

Robotic surgery in these first 20 years of experience has acquired many new information and found application in many fields. In the treatment of certain diseases, as in urological tumors, robotics has become the standard treatment in many indications. In many other fields it is still unclear if there are clinical advantage in comparison with laparoscopic surgery or thoracoscopy.  So far the advantages shown by robotic surgery are mainly related to some indisputable technical advantages over manual minimally invasive techniques due to sophisticated technology. Surgical robot arises from the need to reproduce the same movements and type of dissection performed in open surgery maintaining the advantages of minimally invasive surgery. This is made possible by the instruments capable of performing 360° movements thanks to the degrees of freedom of the robotic arms and articulated tools. Moreover, by means of robotics it is possible to limit the tremor of the hands, amplify the vision 10 times in 3 dimensions and therefore perform movements of extreme precision. Robots currently on the market have shown the advantage of having a mobile arm that allows faster docking, but in the imminent future we will see the presentation on the market of new robots, for example the single-port, capable of further limiting the surgical insult. In thoracic surgery, numerous studies have shown an equivalence of minimally invasive surgery compared to open surgery in terms of oncological radicality, however, other studies have confirmed that the minimally invasive approach is superior in terms of post-operative quality of life and earlier resumption of normal life. If in the initial stages of lung cancer, minimally invasive surgery, manual and robotic, is today the standard of treatment, the new interests for robotic surgeons in the coming years will be addressed to more complex procedures including the treatment of locally advanced cancers after chemotherapy, or segmental resections, perhaps associated with techniques of augmented reality. In this special issue we will review techniques, indications and results of the application of robotic approach in different surgical disciplines, focusing not only on the current standard, but also evaluating future applications and new perspectives.

Dr. Giulia Veronesi
Dr. Pierluigi Novellis
Guest Editors

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