Robotic surgery (Da Vinci)

The Da Vinci Surgical System is a robotic platform that Mr Nguyen controls from a nearby console — he is in the same room, fully in control at every moment. The robot does not act on its own. What it does is translate Mr Nguyen's hand movements into smaller, smoother motions inside your body, through several small keyhole openings in your abdomen.

The system provides a magnified 3D view — like looking through a high-powered pair of binoculars into your body — and its instruments can bend and rotate at angles that ordinary keyhole instruments cannot. These features are particularly useful in the tight space of the pelvis (for rectal cancer surgery and rectopexy) and for complex hernia repair, where working close to delicate nerves and tissues is part of the operation.

The following operations are performed robotically at Warringal Private Hospital. For preparation, what to expect on the day, the full risk discussion, and recovery specific to your operation, please follow the link to the relevant procedure page.

Colorectal

• Anterior resection for rectal cancer — the strongest indication, as the robot's articulation suits the narrow pelvis
• Abdominoperineal resection (APR) for very low rectal cancer
• Right hemicolectomy for right-sided colon cancer
• Subtotal colectomy when multiple cancers or the whole colon needs removing
• Ventral mesh rectopexy for rectal prolapse
• Hartmann's reversal — restoring continuity of the bowel after a previous Hartmann's procedure with end colostomy
• Selected complex diverticular surgery, particularly when there is significant pelvic scarring from prior infection
• Repeat bowel surgery in patients with extensive adhesions from previous operations, where the robot helps with safe dissection

Hernia repair

• Complex inguinal hernia repair using robotic eTEP or robotic TAPP techniques — particularly for large or recurrent hernias
• Ventral and incisional hernia repair
• Abdominal wall reconstruction (AWR) for large or complex hernias
• Parastomal hernia repair

The choice between robotic, conventional keyhole (laparoscopic), and open surgery is made on clinical grounds for each patient — depending on the operation, your anatomy, any previous surgery, and what suits the situation best. The recommended approach will be discussed with you at consultation.

The evidence comparing robotic and laparoscopic colorectal surgery is mixed — large randomised trials have not shown a clear difference in cancer outcomes between the two. The robotic platform offers technical advantages in specific situations (narrow pelvis, complex anatomy, fine dissection close to nerves, working through extensive adhesions), and that is where Mr Nguyen tends to choose it.

There are generally no additional out-of-pocket costs to you for choosing the robotic approach when it is the right tool for your operation.

• Magnified 3D view — up to 10 times normal size — making critical structures, including the fine nerves that run through the pelvis, easier to see clearly
• Wristed instruments — robotic tools can bend and rotate at angles straight laparoscopic instruments cannot, making delicate work in tight spaces easier
• Tremor filtering — the system filters out the natural tremor in any surgeon's hands, useful for fine dissection
• Stable platform — the camera and instruments do not drift, which is helpful for long, technically demanding operations
• All the general advantages of keyhole over open surgery — smaller cuts, less post-operative pain, faster recovery, shorter hospital stay — apply equally to the robotic approach

The major risks of your operation (such as anastomotic leak, bleeding, infection, or nerve injury for pelvic surgery) are determined by the underlying operation, not by which platform is used to perform it — please see the relevant procedure page for the full discussion. The risks that relate specifically to the robotic approach are:

• Switching to keyhole or open surgery — if the robotic approach cannot safely continue, the operation is converted to conventional keyhole or open surgery. This is the right call when it happens; safety always comes first, and the operation is completed.
• Port-site hernia — a small hernia can form at one of the instrument entry points (less than 1%).
• Equipment issues — instrument malfunctions are rare; conventional keyhole instruments are always available as a back-up.

Preparation, fasting, what to expect on the day, and recovery are determined by the underlying operation, not by the use of the robot. Please follow the page for your specific procedure — links are above under "Operations performed robotically".

The one robotic-specific element worth knowing is that the operation involves docking — the robotic arms are connected to the keyhole ports after they are placed. Mr Nguyen then moves to the surgical console a few feet away, where he controls the robot's arms with hand controllers and foot pedals, watching through a high-definition 3D screen. He is in full control throughout; the robot is disconnected at the end and the port sites closed.

A post-operative review is routinely arranged 2–6 weeks after surgery — this appointment is provided at no charge.

Post-operative concerns: Please call our rooms on (03) 9816 3951 and leave a message — this will be sent directly as a text to Mr Nguyen. Alternatively, you may text the office mobile on 0499 090 126. We aim to respond promptly during business hours.

Emergencies: For any life-threatening emergency, call 000 immediately or go to your nearest emergency department. Do not wait for a call back from our rooms. For the Austin Hospital Emergency Department: (03) 9496 5000.