Is the wound made by a robotic arm post-operatively considered an incision?

Terminology for Wounds Made by Robotic Arms Post-Operatively

The wound made by a robotic arm during surgery is correctly termed an "incision," just like wounds created in traditional surgery.

Surgical Wound Terminology

According to the World Health Organization's definition, a surgical wound is "a wound created when an incision is made with a scalpel or other sharp cutting device and then closed in the operating room by suture, staple, adhesive tape, or glue and resulting in close approximation to the skin edges" 1. This definition applies regardless of whether the incision is made manually by a surgeon or through robotic assistance.

Types of Robotic Surgery Incisions

Robotic-assisted surgery typically involves several types of incisions:

• Port incisions - Small incisions (8-12mm) made for insertion of robotic arms, camera, and instruments 1
• Working port incision - A slightly larger incision (15-20mm) through which the tableside surgeon passes instruments and removes specimens 1
• Utility incision - In some cases, a slightly larger incision may be used for specific procedural needs

Port Placement in Robotic Surgery

In robotic-assisted surgery, port placement follows specific patterns:

• Camera port (typically 12mm)
• Instrument ports (typically 8mm)
• Working port (15-20mm)

These incisions are strategically placed to avoid collision of robotic arms while providing optimal access to the surgical site 1.

Wound Care Considerations for Robotic Incisions

Robotic surgery incisions have several advantages over traditional open surgery incisions:

• Smaller size - Typically results in less pain and faster healing
• Less trauma - Studies show that robot-assisted procedures result in significantly less pain during normal activities in the early postoperative period 1
• Lower infection rates - Some studies suggest lower surgical site infection rates with minimally invasive approaches

Post-Operative Management

For optimal healing of robotic surgery incisions:

1. Apply an occlusive dressing for at least 48 hours post-operatively 2
2. Keep the incision clean and dry
3. Monitor for signs of infection (redness, swelling, discharge, increased pain)
4. Follow surgeon's instructions for suture/staple removal (typically 7-10 days) 2

Advanced Wound Management Options

For higher-risk patients or complex procedures, additional wound management strategies may be considered:

• Incisional Negative Pressure Wound Therapy (iNPWT) - Can be applied over closed incisions to reduce infection rates 3, 4
• Steri-Strips - May provide additional support after staple removal, especially in areas where cosmetic outcome is important 2

Conclusion

While robotic surgery represents advanced technology, the wounds created are still properly termed "incisions" and follow the same principles of wound healing and care as traditional surgical wounds. The primary differences lie in their typically smaller size and potentially better outcomes in terms of pain and healing time.