ロボット泌尿器科手術の時代

最終更新日： 2026年8月15日

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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.

• 泌尿器センター バンコク病院 タイ オンライン予約 02-310-3009 bhquro@bdms.co.th
• サミティジ・シラチャ病院 チョンブリ 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
   • 指によるクラッチ機構
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.

ソアラウィー医師は、台湾の長庚記念病院で先進的なロボット泌尿器科トレーニングを修了しました。彼の詳細はこちらをご覧ください。 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.

お客様からよくいただくご質問

Q1: ロボット支援手術とは何ですか？従来の外科手術とどう違いますか？

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：ロボット支援手術で治療できる泌尿器科疾患は何ですか？

ロボット支援手術は、前立腺がんに対するロボット支援前立腺摘除術、腎腫瘍に対するロボット支援腎摘除術、尿管骨盤部分岐部狭窄症に対するロボット支援腎盂形成術、膀胱がんに対するロボット支援膀胱全摘除術など、いくつかの泌尿器科手術においてゴールドスタンダードとなっています。ソラウィー医師は、バンコク病院本部でda Vinci Xiシステムを用いてこれらの手術を行っています。.

Q3：ロボット支援手術は安全ですか？

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.

Q4.ロボット支援泌尿器科手術後の回復期間はどのくらいですか？

ロボット支援泌尿器科手術後の回復は、切開が小さく組織へのダメージが少ないため、一般的に開腹手術よりも早い傾向があります。ほとんどの患者様は1～2週間で軽い活動に戻ることができますが、完全な回復は行われた手術によって異なります。担当医は、手術内容と全身状態に基づき、個別の回復計画を提示します。.

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.

ロボット支援泌尿器科手術についてさらに詳しく知りたい場合、または診察を予約したい場合は、ソアラウィ・ウィーラソポーン医師がバンコク病院本院で専門的な診察を行っております。. 診療をご予約. サミティウェート・シーラチャ病院のご予約は、泌尿器科（電話番号：）までお問い合わせください。 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.

免責事項 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.