QC: Robotic vs. Laparoscopic Surgery

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Dr. Jeff Arrington, renowned excision specialist and patient advocate, shares his expert perspective on the differences between minimally invasive laparoscopic surgery and robotic surgery for endometriosis treatment. He explains that surgical success depends more on the surgeon's training and comfort level with their chosen technique rather than the inherent superiority of either approach.

• Surgeon preference and training are the primary factors in choosing between laparoscopic and robotic approaches
• Dr. Arrington initially used robotics only for complex cases but found several benefits that led to wider adoption
• Robotic surgery reduces surgeon fatigue, potentially extending careers of specialists
• Robotics gives surgeons more control and less dependence on specific OR assistants
• While laparoscopy offers direct tactile feedback, experienced surgeons develop visual cues with robotics
• Both approaches are laparoscopic procedures with different instruments but similar risk profiles

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Episode Transcript

Speaker 1 (00:00):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights.
Short, powerful and right tothe point.
You send in the questions, Ibring in the experts and in just
five minutes you get theknowledge you need.
No long episodes, no extra timeneeded, and just remember

(00:20):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect.
Today I have an incredibleexpert joining us Dr Jeff

(00:43):
Arrington.
If you've spent any time in theendometriosis community, you've
probably heard his name.
Dr Arrington isn't just anexcision specialist.
He's a fierce advocate forinformed consent and breaking
down the barriers that keep somany from accessing proper
endometriosis care.
His passion goes beyond theoperating room.
He's fighting for real change,pushing back against

(01:04):
misinformation and making surethat patients have the knowledge
and options they deserve.
Let's dive in.
Some surgeons use minimallyinvasive laparoscopy surgery,
whereas others use roboticsurgery.
Is there benefit to using oneover the other, and is one more
effective than the other in youropinion?

Speaker 2 (01:24):
Whatever they're trained with and comfortable
with.
Really it's nothing more thanthat.
I mean, my fellowship waspurely laparoscopic and I did.
You know, my first probablyfive plus years of surgery,
purely laparoscopic, and whenrobotics first came out, I saved
it for my most complexendometriosis cases.
They're very, very, very good.
Probably some of the bestsurgeons in the world are

(01:46):
laparoscopic, but there's alsovery, very good, very, very good
, some of the best surgeonsrobotic surgeons.
For me, really, the transitionthat came to robotics when I
first started doing it, itoffered me a couple things.
Number one regular laparoscopy,standing at a patient's side
for hours on end, sometimes fouror five hour cases, but
sometimes eight or nine houroperating days.

(02:08):
I would have to wear Ted hose,I had to take ibuprofen every
day and I'd have to go home andice my knees.
And so robotics.
Number one I think it's goingto extend my career and give me
more time where I can helppatients, but it also allows me
to just get up at the end of theday and walk away.
For me there's less surge infatigue sitting at the console.
I mean, dr Cernervo, he's got alittle stool thing that he sits

(02:32):
on, so he does straight sticklaparoscopy he does okay.
So there's ways to get aroundit Robotically.
It allows me to take morecontrol of the surgery so I rely
less.
It's less important who I havein my operating room Not that I
don't want good people, but youknow, if I don't have my A1 top
assist for that day, not a bigdeal because I've got control of

(02:53):
more instruments of the surgeryand really the assistant is
only there retraction.
So it just gives me morecontrol of the surgery, less
dependent on who else is in theroom there's some concern about.

(03:14):
Certainly laparoscopicallyyou're directly connected to the
instrument so you can feeltissue feedback or what they
call haptic feedback.
Having done both regularlaparoscopy and robotics, I've
learned that over time the bodyis an amazing thing and the body
is an amazing thing and themind is an amazing thing and you
learn a sixth sense roboticallyto tell when there's a problem
with the tissue.
You can tell how, even thoughyou can't feel it.

(03:34):
You can tell when the tissue ismore fibrotic than normal, just
based on the tissue response tothe grasper.
When you're picking things upand seeing things.
It's hard to explain, but themind adapts to it and it's
pretty remarkable.

Speaker 1 (03:47):
Are there risks associated with one or the other
?

Speaker 2 (03:50):
Not that I'm aware of .
I mean, they're bothlaparoscopic procedures, it's
just the instrument that'sdifferent.

Speaker 1 (03:55):
That's a wrap for this Quick Connect.
I hope today's insights helpedyou move forward with more
clarity and confidence.
Do you have more questions?
Keep them coming, send them inand I'll bring you the expert
answers.
You can send them in by usingthe link in the top of the
description of this podcastepisode or by emailing contact
at endobatterycom or visitingthe endobatterycom contact page.

(04:20):
Until next time, keep feelingempowered through knowledge.