Robotic Surgery Q&A with Dr. Wayne Waltzer

In 1985 the first robotic assisted surgery was performed in Vancouver leading to its introduction to the medical world. Today, more than 400,000 robotic surgeries are performed each year in the United States.

Robotic surgery is a minimally invasive procedure- in simpler terms, this means that smaller incisions, marked less than an inch long, are created in order to perform the surgery.

Each robot is made up of multiple robotic arms that are completely controlled by the surgeon. One robot arm has a small 3D video camera while the others utilize specialized surgical instruments used to perform the surgery through the small incisions.

While the surgeon sits at the robot, viewing the 3D image of inside the body, the surgeon’s hand movements are seamlessly translated while entirely controlling the robot.

Dr. Wayne Waltzer, Professor and Chairman of the Department of Urology and Director of the Kidney Transplantation Program, answers some of the most frequently asked questions about general and urologic robotic surgery.


Q: What is robotic surgery?

A: Robotic surgery is a minimally invasive surgery that uses a specific instrument, called the da Vinci Robot, to perform the procedure.The Robot consists of multiple robotic arms controlled by the surgeon at a console.



Q: How does it work?

A: The surgical team starts by inserting trocars, which are “tube like” cylinders, into the area of the body where the surgery is being performed. The trocars hold the tools needed to perform the surgery which are attached to the robot. From there the physician, who has complete control over the robot and the instruments attached, begins to perform the procedure while viewing an enhanced 3D imagine of inside the body.



Q: Does the robot control the surgery?

A: No, this is not the same type of robot that cleans the bottom of your pool! The surgeon completely controls the surgery by manipulating and directing the arms of the robot. The physician has the same “degrees of freedom” as wrist motion to precisely control the robotic arms.



Q: What are the benefits of having robotic surgery?

A: Some of the benefits include small incisions, less blood loss, less use of post-operative pain killers, a shorter hospital stay, and quicker recovery.



Q: What are the risks of robotic surgery? Is it safe?

A: Robotics is a safe surgery. Like any other surgery, there are risks, but robotics uses smaller incisions and has a magnified imagine of inside the body that is 13X the naked eye. This makes it is easier to identify bleeding or complications earlier than in traditional surgery. It is important to know however, that not all surgeries are best performed with the robot. People that have had complex prior surgeries (OR: chemotherapy, radiation, hernia repair with mesh or muscle flaps) may not be ideal candidates.



Q: How long is the recovery time?

A: An average case recovers in the hospital for 1-2 days and a can see a full recovery in 2-4 weeks.



Q: What urologic surgeries can be performed with robotic surgery?

A: A high proportion of oncologic cases can now be performed using the robot as well other benign conditions. For example, radical nephrectomy, partial nephrectomy, radical prostatectomy, cystectomy and ureteral re-implantation and treatment of bladder diverticulum.



Q: Is it more or less painful than traditional urologic surgery?

A:  Robotic surgery is less painful because the incisions are much smaller.



Q: Why should a patient choose to get urologic robotic surgery done at Stony Brook Medicine?

A: The team we have here at Stony Brook Medicine consist of those who are experienced surgeons and have previously trained at elite intuitions.



Q: What is the success rate of robotic surgery?

A: The success rate of robotic surgery is equal to or greater than the success rate of traditional surgery which is still used as the “gold standard” for outcomes.



Q: Are all procedures appropriate for robotic surgery?

A: No, every patient’s situation is unique and should be treated as such. Every procedure, whether traditional or done by using robotics, should be taken on a case-by-case basis.



Q: Is robotic surgery covered by insurance?

A: Yes



The Department of Urology at Stony Brook Medicine has six physicians who perform robotic surgery. Our department is devoted to providing excellent and personalized care for each patient. Our robotic surgeons are well educated, have solid training and advanced experience using the da Vinci Robot. We continue to research and adapt to the best ideas in medicine to continue providing our patients with the utmost care.