Robotic Surgery and the Fight Against the Opioid Epidemic

Dr. Cynthia Geocaris of Surgical Associates of Neenah was one of the earliest adopters of
robotic surgery when she began performing these types of surgeries in 2004. She has
performed thousands of surgeries and teaches robotic-assisted surgery across the country.

Robotic-assisted surgery allows surgeons to perform complex surgeries in a minimally invasive fashion using small incisions and in an outpatient setting.

One of the hidden benefits of robotic surgery is eliminating or reducing the need for narcotic medication after the surgical procedure. It is estimated that 20-30% of patients who are prescribed opioids will end up abusing them. About 5% of opioid users will transition to heroin.

These are scary statistics.

In the Midwest alone, ER visits for opioid overdose are up 70%. The pandemic has been a big contributor to opioid overdose. Unfortunately, prescriptions can be the source of these
tragedies. There are several strategies to avoid or limit narcotic use that are applied in clinical practice.

Robotic-assisted surgery and attention to pain control can allow for surgeries to be done
without narcotics. Another name for this is the enhanced recovery after surgery program or ERAS. This involves setting appropriate preoperative expectations for patients and explaining in detail how to control their pain after surgery. Robotic-assisted surgery is a stable platform that has minimal stress on the abdominal wall. Many believe there is less pain with robotic surgery than traditional laparoscopy.

In robotic-assisted surgery, medications are given prior to the surgery to block the three
different types of pain receptors. Common medications used are Tylenol, Celebrex and
Neurontin. Local anesthetic or a block is used during surgery. After surgery, patients are given no narcotics or only a very small number of pain pills. They are asked to alternate Tylenol and ibuprofen for 48 hours after surgery.

When this protocol is followed for outpatient robotic-assisted hernia repair, 70-90% of patients will not need any narcotic pills. The remainder of these patients may take as few as 5 pills during their recovery. These protocols are also followed for larger robotic surgeries that require an inpatient stay.

Reducing opioid use can have a huge impact on the opioid epidemic and because the use of narcotic medications can cause side effects such as constipation, nausea and dizziness, reduced use of narcotics can reduce these side effects as well. When you avoid narcotics, you tend to feel less groggy and more like yourself.