Since its inception in the 1970s, robot-assisted surgery has been one of the most important achievements of modern medicine and is considered the new “gold standard” for surgical treatment of various diseases in developed countries. Robot-assisted operations are widely used in general surgery, urology, gynecology, and cardiovascular surgery.
For the first time in Georgia and the Trans Caucasia, on March 27, 2024, professor Guram Karazanashvili performed a prostatectomy with robot-assisted technology for prostate cancer, and on July 17, 2024, in the same clinic (Guram Karazanashvili Robotic Center), for the first time in Georgia, Zurab Manizhashvili, associate professor of the Department of Surgery #2 of Tbilisi State Medical University, performed resection of the sigmoid colon due to a tumor of the sigmoid colon and the formation of a descending-recto anastomosis with a circular stapler.
In the near future, it is planned to perform robot-assisted operations in the field of gynecology.
Nowadays, there are the following operative approaches to the abdominal cavity in the world: traditional or open abdominal surgery, already introduced and popular endoscopic or laparoscopic surgery and already introduced at the Guram Karazanashvili Robotic Center, robotic operations recognized as the gold standard in the world with minimal burden on the body, i.e. robot-assisted surgery. Four months after its introduction, more than 50 successful surgical interventions have already been performed.
Advantages of robotic surgery compared to other methods (both open and laparoscopic approaches):
Ø Correct pre-operative installation (docking) of the equipment is carried out before the operation.
Ø Operations are carried out with minimum load on the body, i.e. it is a mini-invasive operation.
Ø During robotic surgery, the image on the monitor is close to a three-D image, which exceeds even the capabilities of advanced 3-D laparoscopic systems. The development of robotic intraoperative three-dimensional imaging systems has shown that visualization, not palpation, is the main thing for a surgeon in the era of modern technology.
Ø The image is magnified 10 times, so the image of the image is more accurate.
Ø The movement of the remotely controlled robot’s hands is in agreement and synchronous with the surgeon’s hand movement, and is more refined, gentle and performs more precise movements compared to human hands.
Ø During the robotic surgery, during the movement of the robot’s hands controlled remotely by the surgeon, there is no physiological tremor of the hands, which is typical for laparoscopic and open surgeries.
Ø During operations performed with robotic surgery, the load on organs and the degree of tissue trauma are reduced. High accuracy of instrument movements reduces intraoperative blood loss and also shortens operative intervention time.
Ø The precision of movement of mechanical manipulators exceeds the capabilities of human hands, as they have seven degrees of freedom and the ability to bend 90 degrees. A 3D image of the enlarged operating field appears on the monitor screen.The surgeon controls the manipulators using touch-sensitive joysticks, and the movements of the surgeon’s hands are performed with absolute precision by robotic instruments, which provides improved articulation, simplifies the technique of placing sutures, and allows the most complex manipulations to be performed with maximum precision. Finally, this ensures a high quality of the operation and increases the safety of its implementation.
Ø During robot-assisted operations, the workload and fatigue of the surgeon is reduced, since the surgeon performs the operation in a sitting position, the head and hands are comfortably positioned.
Ø During the operation, the risk of infection is reduced, since the operator or any member of the operating team has no contact with the operation field.
Ø Advantages include: quick recovery of operated patients, short hospitalization, reduced postoperative rehabilitation, short social adaptation of patients.
Ø Robotic assisted surgery can be more expensive than traditional surgery due to the use of modern robotic technology. However, despite the higher initial cost, robotic surgery results in cost savings due to shorter hospital stays, faster recovery times, and fewer complications.
Robotic surgery is used in all areas of surgery: urology and oncology: radical prostatectomy with extended lymphadenectomy, radical or partial nephrectomy, adrenalectomy, plastic surgery of the ureter segment; General surgery and oncological operations: in the case of hepatobiliary, pancreatic, stomach, spleen, small, large and rectal surgical pathologies, as well as bariatric operations and plastic and reconstructive operations of hernias.
Today, robot-assisted surgery is firmly in the leading position in the world, with 11 million robot-assisted surgeries performed from 2007 to 2024 according to literature data. 90 percent of U.S. prostatectomies are performed robotically.
During robotic surgery, the operation is completely managed by the surgeon, and the robot provides such precision and sophisticated surgical results that are unattainable by human hands and eyes, therefore, the use of a highly qualified surgeon and the best robotic technology gives the patient the maximum result of the treatment.
In addition to robot-assisted surgery techniques, the surgeon must also possess laparoscopic and open abdominal surgery techniques, since conversion may be necessary considering the human factor. That is why the surgeons of professor Guram Karazanashili’s clinic possess all the necessary methods for surgical intervention available today.
