What is RAS? Understanding Robot-Assisted Surgery

RAS stands for Robot-Assisted Surgery, a modern surgical approach where advanced technology is used to support the surgeon during minimally invasive procedures. In Upper GI surgery, RAS allows for enhanced precision, improved visualisation and greater control, particularly in complex or delicate operations.

In this article, we cover:

• What RAS (robot-assisted surgery) means
• How robot-assisted surgery works
• How RAS differs from traditional and laparoscopic surgery
• Where RAS is used in Upper GI procedures
• When it may be considered

What is RAS? Understanding Robot-Assisted Surgery

Robot-assisted surgery is performed through small incisions, similar to laparoscopic (keyhole) surgery.

During the procedure:

• A high-definition 3D camera provides a magnified view of the surgical area
• Robotic instruments allow for a greater range of motion than standard instruments
• The surgeon controls all movements from a console

This setup can enhance precision, particularly in areas where space is limited or anatomy is complex.

How is RAS different from laparoscopic surgery?

Laparoscopic surgery remains the standard approach for many Upper GI procedures and continues to provide excellent outcomes. Robot-assisted surgery (RAS) builds on this by offering additional technical capabilities. 

In laparoscopic surgery, long, straight instruments are used with a typically 2D view, and it is highly effective for many routine procedures. RAS, by comparison, provides a magnified 3D view, greater instrument flexibility and more refined control of movements. 

It is not required for all patients, but it may offer advantages in selected cases where additional precision is beneficial.

How many different Robotic Platforms for general surgery are there?

The Intuitive da Vinci robotic surgical system is the most frequently used platform in the world, having been in use for > 20 years for many applications, and for Upper GI surgery in Australia since 2014. The da Vinci also has other platforms, including a Single Port system that can provide “scarless surgery”. Medtronic has the Hugo RAS system, which has been available for 3 years in Australia, and many more will soon be available.

Where is RAS used in Upper GI surgery?

Robot-assisted surgery can be used across a range of Upper GI procedures, including:

• Hernia repair
• Reflux surgery (fundoplication and hiatus hernia repair)
• Bariatric surgery (such as gastric sleeve and gastric bypass)
• Selected gallbladder procedures
• Cancer surgery for the oesophagus and stomach
• Removal of benign tumours of the oesophagus or stomach

Its role is to support the surgeon in achieving a safe and precise outcome, particularly in more complex cases..

When is RAS considered?

The use of robot-assisted surgery depends on a number of factors, including:

• The type and complexity of the condition
• Previous surgery or scar tissue
• Individual patient anatomy

In many straightforward cases, laparoscopic surgery remains the most appropriate option. RAS is best viewed as an additional tool that can be used where it offers a clear advantage.

A considered approach to surgical technique

Robot-assisted surgery is an important development in modern surgical practice. However, it is not a one-size-fits-all solution.

The focus is always on selecting the most appropriate approach for each patient — whether that is laparoscopic, robotic or, in some cases, open surgery.

Understanding your options — including whether a robotic approach is appropriate — can help you make an informed decision about your care. Contact our team if you would like more information or to book an appointment with one of our specialists.