The word "robot" can give the wrong impression. A surgical robot does not think, decide or move by itself. Every movement it makes comes directly from the surgeon's hands. It is better described as a highly advanced set of instruments that allows the surgeon to work through small incisions with great precision. Understanding how it works can make the idea of robotic surgery feel much less unfamiliar.
The three main parts
Most surgical robots used in the UK have three main parts.
- The surgeon console: where the surgeon sits, a few metres from the patient, viewing the operation and controlling the instruments.
- The patient cart: the unit beside the operating table that holds the robotic arms.
- The vision system: the camera, light source and screens that let the whole team see the operation.
The surgeon console
At the console, the surgeon looks into a viewer that shows a magnified, three-dimensional image from inside the body. Their hands rest on two finger controls, and their feet operate pedals that switch between instruments, move the camera and control energy used to seal blood vessels.
When the surgeon moves their hands, the instruments inside the patient follow, scaled down to very small, precise movements. If the surgeon lifts their head away from the viewer, the instruments stop moving. This is one of several safety features.
The robotic arms
The patient cart usually has three or four arms. One holds the camera and the others hold instruments such as fine graspers, scissors and needle holders. These instruments pass into the body through small ports, each around one centimetre across.
A key feature is the wrist at the tip of each instrument. It can bend and rotate further than a human wrist, which makes it easier to work in tight spaces such as the pelvis, where the prostate sits. The system also filters out the small natural tremor in a surgeon's hands.
Some newer systems use a single port, allowing all instruments to pass through one small incision. Our article on single port robotic surgery explains this approach.
3D vision and magnification
The camera gives a high-definition, three-dimensional view, magnified around ten times. This helps the surgeon see small structures, such as the nerves that control erections and the muscle that controls continence. Our article on the SAFE technique shows how this level of detail supports nerve-sparing surgery.
Some systems can also display MRI images alongside the live view, helping the surgeon relate the scan to what they see.
The team in theatre
The surgeon is not alone. The team includes:
- an anaesthetist, who looks after the patient's anaesthetic and wellbeing
- a bedside assistant, who changes instruments and helps with suction and retraction
- scrub nurses, who prepare and pass instruments
- operating department practitioners
The team can see the operation on screens around the theatre and communicate with the surgeon throughout.
Why this helps patients
Compared with open surgery, robotic surgery usually means:
- smaller incisions
- less blood loss
- less pain after the operation
- a shorter hospital stay
- a quicker return to normal activities
Our robotic prostatectomy page explains the operation itself.
The surgeon's skill still matters most
The robot is a tool. Results depend on the skill, training and experience of the surgeon using it. The Royal College of Surgeons sets standards for surgical training in the UK, including robotic surgery. Prostate Cancer UK has further information on how robotic prostatectomy is performed.
Professor Prokar Dasgupta has worked with surgical robots for more than two decades and has helped develop techniques now used widely. You can read more on our page about expert robotic surgery, or contact the clinic to arrange a consultation.