KEY POINTS:
Would you trust your prostate operation to a robot or does the very idea bring tears to your eyes?
Now, for the first time here, surgical procedures are to be carried out by remote control - where the surgeon handles a computer rather than scalpels and the cutting
is done by a diminutive robotic claw.
The operations will make their debut in three months' time where the first live demonstration of robotic surgery will probably be the removal of a man's diseased prostate gland.
The Australasian agent for the maker of the equipment, called the da Vinci system, is organising the promotional demonstration with Auckland's MercyAscot private hospitals' company.
The units costs about US$1.5 million ($2.03 million) and, worldwide, 500 of them are in use, including four in Australia.
Developed in the 1990s, they are, like keyhole surgery, a form of minimally-invasive treatment.
As with keyhole (laparoscopic) surgery, viewing and surgical instruments are inserted into the patient's body through small surgical incisions. In laparoscopic surgery, the surgeon manipulates the instruments directly by using handles that poke out through the incisions.
But with the da Vinci "robotic surgery" unit, the instruments are instead attached to up to four electro-mechanical arms. They are controlled through a computer. The surgeon sits at a console, looking at a video image of the patient's internal organs on screen and manipulates the instruments through specialised computer controls.
The manufacturer, Intuitive Surgical, says its unit's video image is three dimensional and superior to that available in laparoscopic surgery. And the unit's instruments offer a range of motion that mimics the dexterity of the human hand and wrist, although it is considered to be quicker and safer than the human hand.
"The da Vinci system seamlessly translates the surgeon's hand movements at the console instrument controls into corresponding micro-movements of instruments positioned inside the patient."
The US company says benefits of its system may include shorter hospital stays, less pain and infection risk, less blood loss, less scarring and quicker recovery.
Traditional prostate surgery requires a 20 to 25cm incision from the navel to the pelvic bone and recovery time is five to six weeks. Furthermore, it can come with unpleasant consequences such as incontinence and impotence.
The system could theoretically be used for long-distance surgery but that is not the main focus of the equipment's development.
The units have been used for a range of operations, including kidney transplants and hysterectomies. Newsweek said the robotic units had transformed prostate surgery and were expected to be used in more than 40 per cent of such operations in the United States last year.
"It's exciting and cutting-edge," a College of Surgeons leader, Wellingtonian John Simpson, said yesterday. "People attracted to the cutting edge are the ones that will tend to go for it."
Dr David Sage, chairman of the National Service & Technology Review Advisory Committee, which assesses new medical equipment for general introduction to the health system, said it was interested in robotic surgery - to a degree.
"At the moment, it hasn't got on to our possibilities list because it's still out there on the horizon," he said.
"It's probably the way of the future for sure. There's huge interest in it from surgeons at the moment [but] the costs are prohibitive."
MercyAscot chief executive Andrew Wong said it was arranging the demonstration for surgeons to see whether it was worth considering buying a unit. There was debate over whether the outcomes for patients were much better than with laparoscopic surgery.
