Robotic Surgery

Robotic Surgery

Robotic Surgery is a rapidly expanding specialty that enhances precision, visualization, and minimally invasive access across multiple surgical fields. CSTs in robotic surgery support procedures performed with robotic platforms such as the da Vinci system, requiring mastery of robotic setup, docking, instrumentation, and troubleshooting. This specialty demands strong technical skills, deep understanding of minimally invasive workflows, and the ability to coordinate closely with surgeons and bedside assistants during complex robotic procedures.

Role of CSTs

  • Prepare robotic instrument sets, laparoscopic tools, and specialty trays for robotic procedures across multiple specialties.
  • Assist with patient positioning, prepping, and draping for robotic access and port placement.
  • Dock the robotic system and ensure proper alignment with trocars and target anatomy.
  • Anticipate surgeon needs during instrument exchanges, suctioning, stapling, and specimen retrieval.
  • Manage robotic instruments, energy devices, and endoscopic equipment.
  • Troubleshoot robotic arms, camera systems, and instrument recognition issues.
  • Support emergency conversions from robotic to laparoscopic or open surgery.
  • Assist with accurate counts, instrument tracking, and efficient room turnover.

Essential Skills

  • Strong understanding of robotic platforms, components, and instrument functions.
  • Proficiency with trocar placement, docking, and robotic arm positioning.
  • Ability to anticipate surgeon needs during robotic dissection, suturing, and energy use.
  • Skilled in managing robotic instruments, staplers, and specimen retrieval tools.
  • Competence with laparoscopic towers, insufflation, and energy devices.
  • Ability to maintain sterile technique around large robotic equipment.
  • Effective communication with surgeons, anesthesia, and bedside assistants.
  • Adaptability for multi‑specialty robotic workflows.

Common Procedures

  • Robotic hysterectomy and myomectomy
  • Robotic prostatectomy and nephrectomy
  • Robotic cholecystectomy and hernia repair
  • Robotic colectomy and rectal surgery
  • Robotic bariatric procedures (gastric bypass, sleeve gastrectomy)
  • Robotic thoracic procedures (lobectomy, mediastinal surgery)
  • Robotic ENT and head & neck procedures (select centers)
  • Robotic endometriosis excision
  • Robotic adrenalectomy
  • Robotic pelvic floor reconstruction

Instruments & Equipment

Instruments

  • Robotic instrument sets (graspers, scissors, needle drivers, bipolar tools)
  • Robotic staplers and energy devices
  • Laparoscopic instruments for bedside assistance
  • Trocars and port placement tools
  • Specimen retrieval bags
  • Suction and irrigation instruments
  • Suture and needle handling tools
  • Clip appliers and stapling devices

Equipment

  • Robotic surgical system (console, patient cart, vision cart)
  • Endoscopic camera and 3D visualization system
  • Insufflation units and tubing
  • Electrosurgical generators
  • Laparoscopic towers and monitors
  • Positioning devices for steep Trendelenburg or lateral access
  • Smoke evacuation systems
  • Robotic arm drapes and sterile barriers

Workflow & Case Progress

  1. Room setup with robotic instruments, laparoscopic equipment, and energy devices.
  2. Patient positioning based on specialty (Trendelenburg, lithotomy, lateral, supine).
  3. Prepping and draping with attention to robotic arm access.
  4. Trocar placement and initial laparoscopic access.
  5. Docking the robotic system and aligning arms with target anatomy.
  6. Robotic dissection, suturing, resection, or reconstruction.
  7. Instrument exchanges, suctioning, and assistance at the bedside.
  8. Specimen retrieval and hemostasis.
  9. Undocking, closure of trocar sites, and final counts.
  10. Transfer to PACU with appropriate handoff.

Sterile Technique Considerations

  • Maintain sterility during robotic arm draping and docking.
  • Protect the sterile field during robotic arm movement and repositioning.
  • Handle robotic instruments carefully to avoid contamination of the sterile field.
  • Maintain sterile technique during emergency conversions to open surgery.
  • Manage long instrument shafts and cables without contaminating the field.
  • Ensure sterile technique during high‑movement, multi‑arm robotic workflows.

Career Pathways

  • Robotic Surgical Technologist
  • Multi‑specialty robotic OR specialist
  • Robotic program coordinator
  • Robotic First Assist (with additional training)
  • Clinical educator for robotic instrumentation and workflows
  • Device representative for robotic platforms and instruments
  • Robotic docking specialist
  • Minimally invasive surgery technologist

How to Prepare

  • Study robotic system components, instrument types, and docking workflows.
  • Learn trocar placement patterns for different specialties.
  • Practice draping robotic arms and troubleshooting common errors.
  • Review robotic workflows for hysterectomy, prostatectomy, hernia repair, and colorectal surgery.
  • Observe robotic cases to understand pacing and bedside assistant responsibilities.
  • Strengthen sterile technique for large‑equipment environments.
  • Build familiarity with energy devices, staplers, and laparoscopic fundamentals.