When I was in medical school (decades ago), we had a lecture by one of the pioneers of endoscopic gall bladder surgery (cut some 1-2cm slits and use long-handled tools and a tiny camera to cut/remove/etc) which I well knew was already preferable to the "open procedure" that slashed the patient open (classic surgical proverb: you can never have too much exposure) so you could have the working space to reach in and do it with your big mitts)
I was a big fan, but as a student of both philosophy and the history of science I had to ask how he justified performing the procedure *before* (until) he got the complication down to the level of the standard open incision. He was outraged (as were my classmates) and tersely stated that he had gotten consent (not knowing that I'd done a thesis on the inadequacies and inherent ludicracy[sic] of getting "informed consent", especially based on information from the surgeon who wishes to do the procedure).
It was a sincere question, one that I felt could not answer to my own satisfaction (his answer didn't help; he'd simply been looking to "the medical advance" and had never been trained in genuine ethics), but despite that, I feel that he had done the right thing, and that tens of millions have greatly benefited since.
I think you answered your own question right there. The benefits of the procedure outweighed the risks. Informed consent, even for risky surgery, is still valid....so long as you properly inform the patient of the risks and benefits of the procedure. The patient gets to make their own decision. I consent patients for emergent (crash) procedures on a frequent basis. They are so sick that they may not survive the operation; however, without one they will certainly die. Most choose to take the risk. (Some decide that enough is enough and wish to be made comfortable, which is a valid option)
Now you can always argue that the patient, not being a physician, will never truly understand the risks, but that's the imperfect world we live in. OTOH, if this physician did not go through all of the risks, then that's another story.
Though not all would-be 'medical advances' end so salubriously, the sad fact is, we don't know any better way -- and I'd wager that we'll have workable fusion generators long before we have a better usable method for making medical advances. "First, do no harm" was a simplistic principle suited to the era before Christ when a doctor was as/more likely to do harm as/than good. (Note that the Hippocratic Oath forbids surgery outright)
We are now skilled enough that some of our advances seem "too good to deny to all comers" without full data -- but where are we to get that data, except by trial (and error). We are not yet advanced enough that MOST of our attempts at medical advance are so beneficial, nor are we advanced enough to have a much better alternative to "try it and see".
Now here's the rub....is robotic surgery any better, or offer benefit above, laparoscopic surgery? I will say with a decent amount of authority, there are very few procedures that have any advantage done robotically (namely those deep in the pelvis) - but note, they can still be done laparoscopicallyor even open. But there are very inherent risks....the robot removes all haptics from the surgeons hands (versus being mildly reduced in laparoscopic procedures). The first exercise you ever do with a robot is rip a piece of suture apart....you never get to feel how much tension is on it - so you "learn" what the limits look like, as opposed to feel like. There are other things inherent to the robot that also make it more difficult such as clutching (think of how you lift your mouse to move it back to the center of the mouse pad when you try to scroll a long distance) and the lack of knowledge of where your instruments are pointing.
To a lot of surgeons out there, robotic surgery is a solution looking for a problem. The worst part is....the uninformed public things that "robotic surgery" must be better. It is not. It is mostly a marketing tool. A robot will not make a poor surgeon better, it just gives them an excuse to hide behind....
Disclaimer: I am a surgeon. I have used the robot (but not been certified in it is use), and I refuse to become certified A) because it offers no benefit in my elective cases B) it is contraindicated in my emergent cases (the majority) and C) as I stated, I do not believe in the benefits.
Couldn't something like this be practiced on animals first? If you want to stay in good w/ the ASPCA, become a vet for a while (seriously).
Secondly, are there cases (extreme obesity?) where endoscopic or laproscopic procedures have a particular advantage, such that the possibly greater risks of the new procedure are outweighed by the known risks of a standard procedure for such cases?
The certification process, as I understand it, requires you to perform surgery using animals for the initial certification, later, you perform several surgeries on people while being proctored.
There are several surgeries that are much easier, and less morbid when done laparoscopically, but they can still be done open. There is no surgery that is done currently that must be done laparoscopicallyor via a robot - all can be done openly - and open is the fall back when you encounter problems laparoscopicallyor via robot.
For those who have not seen it, this link shows a video that (on my quick perusal) adequately shows a simple procedure done with the robot.