Inside the Robotic Console

Every robotic surgery begins, like all surgery, with preparation. And then, always, a knife.

The first part is almost architectural. We insert ports into the patient's abdomen: small entry points through which everything else will follow. The first port, most of the time, goes through the umbilicus. Before placing it, we take a small look inside, a brief glimpse at what we are about to enter. Then we inflate the abdomen slightly, creating space, a kind of interior room where we will work.

Once all instruments are in position, I move to the console.

In our operating theatre, the console is in the same room. I can see my team from where I sit: my assistant surgeon, the nurses, the quiet choreography of people who know exactly what they are doing. I speak through a microphone, and my voice comes out through the speakers, heard everywhere in the room. When they need to reach me, they speak a little louder, so their voices carry back through the system. Somewhere in the background, music plays: low, unobtrusive, a thread of sound beneath everything else. I hear the room the whole time: the beeping of monitors, the clicking and hissing of the equipment, the particular rhythm of a patient who is stable and being cared for.

And yet. When I place my head into the console, I move into another dimension.

The view is unlike anything in any anatomical atlas I have studied. I am surrounded by tissue, by structure, by the extraordinary machinery of a living body at work. Everything is in motion. The intestines shift and squeeze, moving their contents along. The heart beats, visible through the diaphragm. There are respiratory movements - a gentle, rhythmic rise and fall. And then there are the arteries.

The arteries are the most magnificent and the most frightening things I know.

Whenever I approach one, I hold my breath. Something in me quiets. Please, I think, do not bleed. The robotic arms move under my direction through small, fluid, consistent movements. And as the surgery continues, the outside world does not disappear, I can still hear it, still feel it around me, but it narrows. There is only this: the tissue, the instruments, the next careful step.

Immersed. Step by step, until the end.

And then it is finished.

If it has been a long surgery, I feel it when I come out. Stiffness in my hands, in my legs. I started wearing compression socks on those days, a small concession to the hours of stillness that operating demands. There is tiredness, visible if you know where to look. But there is also something else: a rush of completion, something close to euphoria. The satisfaction of having seen it through.

And then, quietly, the uncertainty.

Will it work out the way I want?

I believe it will. I hope it will. But the hoping never fully goes away, not after the last instrument is out, not when I walk to speak to the waiting parents, not even later. That small thread of uncertainty is, I think, part of what keeps us careful. It is not doubt in what we did. It is respect for what comes next - the healing that belongs entirely to the patient now, no longer to us.

I finished. The rest is theirs.