L'era della chirurgia robotica in urologia

Ultimo aggiornamento: Agosto 15, 2026

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Robotic urology surgery has earned its reputation, and for several operations — robotic prostatectomy above all — it is now considered the gold standard. This article covers the whole story: where the technology came from, what it is used for, what it does well, where it falls short, and where it is heading.

• Centro di urologia Ospedale di Bangkok Thailandia Prenotazione online 02-310-3009 bhquro@bdms.co.th
• Ospedale Samitivej Sriracha Chonburi 088-022-1445

The story begins in the 1980s, and not in an operating theatre. Research into human spaceflight and battlefield medicine produced the first of two key components: a three-dimensional head-mounted display. The second, a telemanipulation instrument allowing a surgeon to operate at a distance, came out of work at Stanford aimed at military use. At the same time laparoscopic surgery was developing rapidly, and the idea of combining these technologies into what we now call robotic surgery became plausible.

History of robotic urology surgery

In the early 1990s two US companies were competing to build it.

• Computer Motion Inc.
• Intuitive Surgical

Intuitive Surgical’s “da Vinci” system succeeded so decisively that the company went on to acquire Computer Motion, and it has effectively held the field ever since.

Five generations of the da Vinci system have followed.

1. da Vinci 2000
   • Early 2000s, designed for coronary surgery but usable for urological procedures
2. da Vinci S
   • Mid-2000s, improved instrument arms and setup
3. da Vinci Si
   • 2009
   • High-definition visualisation
   • Meccanismo di frizione basato sulle dita
4. da Vinci Xi
   • 2014
   • 3D vision through a smaller-calibre camera port
   • Slimmer robotic arms
   • Multi-quadrant surgery becomes possible

5. da Vinci SP
   • 2018
   • Single-port surgery — every instrument passes through one incision

Advantages of robotic urology surgery

• Much smaller wounds than open surgery, with considerably less blood loss and less pain afterwards.
• Smaller wounds mean faster recovery.
• The robotic arm has a far greater range of motion than the human wrist and than laparoscopic instruments, which allows more precise work and makes more complex operations feasible.
• Magnified three-dimensional vision, which matters most when operating deep in a small space — exactly the situation in most urological surgery.

Limitations of robotic urology surgery

• Operating time can be longer than open or laparoscopic surgery because of the time spent docking the robotic arms, although this narrows considerably with an experienced robotic surgeon.
• It costs more.
• It requires a properly trained robotic surgeon.
• If an emergency arises during the operation, the surgeon may need to convert to open or laparoscopic surgery.
• It is not the right choice for every operation.
• It is not available in every hospital, so patients need to seek out a centre that offers it.

What the robot does not change

It is worth being clear about one thing that gets lost in the enthusiasm. Robotic surgery is a route into the body, not a different operation. A robotic prostatectomy removes the same prostate as an open prostatectomy, and the risks that belong to the operation itself remain: bleeding, infection, injury to nearby structures, blood clots in the legs or lungs, and the functional consequences specific to the procedure — for prostatectomy, that means erectile dysfunction and a period of urinary incontinence, neither of which the robot abolishes.

The other honest point is that outcomes track the surgeon more closely than the machine. A well-trained robotic surgeon with volume in the particular operation is what makes the difference; the presence of a da Vinci system in a hospital brochure is not, on its own, a quality measure. It is a fair question to ask any surgeon how many of your particular operation they perform.

After any robotic or laparoscopic urological operation, some symptoms need to be reported rather than waited out: fever or shaking chills, increasing rather than settling abdominal pain, a wound that becomes red, swollen or starts discharging, calf pain or swelling, sudden breathlessness or chest pain, and inability to pass urine once the catheter has been removed. Sudden breathlessness or chest pain means an emergency department, not a phone call.

Bangkok Hospital Headquarters is fully equipped with the da Vinci Xi system and has a qualified team covering all robotic urological operations. If you are weighing up whether robotic surgery is right for your condition, that is a conversation to have with a robotic surgeon who can assess your particular case.

Il Dr. Soarawee ha completato la formazione avanzata in urologia robotica presso il Chang Gung Memorial Hospital, Taiwan. Scopri di più su di lui international surgical training.

The most established application of this technology is in prostate cancer surgery. Read more about robotic prostatectomy at Bangkok Hospital, including nerve-sparing technique and functional recovery.

Domande frequenti

La chirurgia urologica robotica è un tipo di intervento chirurgico minimamente invasivo che utilizza un sistema robotico avanzato. Il chirurgo controlla gli strumenti robotici da una console, che offre una visione tridimensionale ingrandita del campo operatorio. La differenza principale rispetto alla chirurgia convenzionale (o "a cielo aperto") risiede in: * **Tecnologia:** La chirurgia robotica utilizza bracci robotici guidati dal chirurgo, mentre la chirurgia convenzionale richiede incisioni più ampie e l'uso diretto delle mani del chirurgo e di strumenti tradizionali. * **Minimizzazione dell'invasività:** Nonostante entrambe possano essere minimamente invasive (la chirurgia convenzionale può anche essere laparoscopica), la chirurgia robotica offre solitamente incisioni più piccole, minori traumi ai tessuti e un recupero più rapido. * **Visione e precisione:** La console robotica offre una visione 3D ad alta definizione e ingrandita, consentendo al chirurgo maggiore precisione, destrezza e un migliore controllo dei movimenti rispetto a un'incisione aperta tradizionale o anche alla chirurgia laparoscopica 2D. * **Recupero:** Generalmente, i pazienti sottoposti a chirurgia robotica sperimentano meno dolore, una minore perdita di sangue, cicatrici più piccole e un ritorno più rapido alle normali attività rispetto alla chirurgia convenzionale.

Robotic urology surgery uses the da Vinci surgical system to perform minimally invasive operations with robotic arms controlled by the surgeon. Compared to open surgery, it offers smaller wounds, less blood loss, less postoperative pain, and faster recovery. The 3D magnified visualization and greater range of motion of robotic arms also allow for greater surgical precision, especially in deep and confined anatomical spaces typical in urology. The robot is the route of access; the operation performed inside is the same one.

Q2: Quali condizioni urologiche possono essere trattate con la chirurgia robotica?

La chirurgia robotica è il gold standard per diverse procedure urologiche, tra cui la prostatectomia robotica per il cancro alla prostata, la nefrectomia robotica per i tumori renali, la pieloplastica robotica per l'ostruzione del giunto ureteropelvico e la cistectomia robotica per il cancro alla vescica. La dottoressa Soarawee esegue queste procedure presso il Bangkok Hospital Headquarters utilizzando il sistema da Vinci Xi.

Q3: La chirurgia urologica robotica è sicura?

Yes. Robotic urology surgery has an established safety profile supported by extensive clinical evidence. However, it is still major surgery: bleeding, infection, injury to nearby structures, blood clots and the functional consequences specific to each operation remain possible, and the robotic approach does not remove them. Outcomes depend more on the surgeon’s training and case volume than on the machine itself, and in an emergency the surgeon can convert to open or laparoscopic surgery.

Quanto dura il recupero dopo un intervento urologico robotico?

Il recupero dopo un intervento di urologia robotica è generalmente più rapido rispetto alla chirurgia a cielo aperto, grazie a incisioni più piccole e a un minore trauma tissutale. La maggior parte dei pazienti può riprendere attività leggere entro 1-2 settimane, sebbene il recupero completo dipenda dalla procedura specifica eseguita. Il vostro chirurgo fornirà un piano di recupero personalizzato in base all'intervento e al vostro stato di salute generale.

Q5: What symptoms after robotic surgery should I report?

Contact your surgical team promptly for fever or shaking chills, abdominal pain that increases rather than settles, a wound that becomes red, swollen or starts discharging, calf pain or swelling, or inability to pass urine after the catheter is removed. Sudden breathlessness or chest pain requires an emergency department immediately, as it can indicate a clot in the lung.

Q6: Is robotic surgery available at Bangkok Hospital Headquarters?

Yes. Bangkok Hospital Headquarters is equipped with the da Vinci Xi robotic surgical system, one of the most advanced generations available. Dr. Soarawee Weerasopone, who completed robotic surgery fellowship training at Chang Gung Memorial Hospital in Taiwan, performs robotic urological procedures at the hospital.

Se desideri saperne di più sulla chirurgia urologica robotica o prenotare una consulenza, la dottoressa Soarawee Weerasopone offre consulenze specialistiche presso la sede centrale dell'ospedale di Bangkok. Prenota una consulenza. È possibile fissare un appuntamento presso l'Ospedale Samitivej Sriracha chiamando il reparto di urologia al numero 088-022-1445.

Bangkok Hospital also runs a Telemedicine service, which is often the practical first step for patients travelling from abroad to discuss whether a robotic operation is the right route in their case — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Imaging, examination and the pre-operative assessment are done in person. Samitivej Sriracha is in-person only.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Robotic surgery is an approach to an operation and does not remove the risks of the operation itself; whether it suits your case can only be decided after assessment. No medical advice, diagnosis or prescription is provided through personal messaging channels. Always consult a qualified healthcare professional before starting any medical treatment.