Colorectal Surgery and Robotic Surgery

Colorectal cancer is characterised by a significant increase in its incidence in recent years. Age is an important factor in the occurrence of the disease, as the majority of patients are over 65 years of age. Early diagnosis is of paramount importance for its prognosis. Colon cancer is treated by surgery and nowadays it is best done robotically due to its many advantages.

Robotic Surgery is a new minimally invasive surgical method, which is the evolution of laparoscopic surgery. Possessing all its advantages and free of all its disadvantages, the robotic method is the method of choice for the definitive treatment of many conditions.

 

What are the causes of colorectal cancer and what are the symptoms?

The causes of colorectal cancer are not fully known in the medical community. The factors that have been implicated as contributing to its development are age, unbalanced diet, inflammatory bowel disease, smoking, polyps, etc.

The symptoms that occur and are associated with colon cancer are as follows:

• Blood in the stool
• Changes in bowel habits (diarrhoea or constipation)
• Pain in the abdomen
• Pain in the abdomen or intestinal distress
• Unexplained weight loss
• Feeling of incomplete emptying
• Anaemia

 

How was bowel cancer treated before robotic surgery?

The surgical method for treating colon cancer is that of a colectomy. A colectomy removes part or all of the colon and the lymph nodes in the area if and when necessary. In cases where part of the colon is removed, the remaining parts are reconnected by means of anastomosis. Anastomosis may be performed either endosomally or extracorporeally.

Before the advent of robotic surgery, colectomy was performed by the traditional open method. However, open colectomy required large incisions, which, in addition to pain, created many complications postoperatively and delayed the patient’s return to daily activities. Thus, the disadvantages of open colectomy created the need to design minimally invasive techniques such as laparoscopic and – the most modern – robotic colectomy.

Bowel Cancer & Robotics: Treating colorectal cancer with the latest tools

The first robotic colectomy was performed in 2002 and since then the number of robotic general surgery surgeries has been growing. The knowledge and expertise of the surgeon with the help of the robotic system pays off to the maximum extent, as it enables him to operate with extremely high precision.

The da Vinci robotic system with its high-resolution (3D) and magnified (x10) 3D image offers the surgeon a complete view of the surgical field. Also, the flexibility of the robotic instruments enables the surgeon to operate even in very limited space (e.g. obese patients or patients with tumours near the anus).

What are the advantages of robot-assisted colectomy?

The advantages of robot-assisted colectomy are many and that is why the number of robotic surgeries is increasing. In particular, robotic colectomy offers:

• Less blood loss
• Shorter incisions
• Less chance of surgical wound infections due to the small incisions
• Minimization of postoperative pain due to smaller incisions due to smaller incisions
• Fewer post-operative complications due to the small number of surgical incisions
• Minimisation of patient hospitalisation
• Faster return of patients to their daily activities
• Better aesthetic result due to small incisions
• Reduction in the incidence of near-natural seating (colostomy)
• Minimization of the possibility of converting the surgery into an open surgery
• Oncological benefits
• Lower number of local recurrences

In conclusion, bowel cancer and other bowel-related diseases can be treated directly and without complications with robotic surgery. However, this surgery requires specialization and thus should be performed by trained surgeons with experience in handling robotic systems.

Dr. Thalia Petropoulou, a qualified surgeon, is a Certified Specialist Consultant Lower Digestive Surgeon. She is the only holder of the International Robotic Colorectal Fellowship in Greece, and is fully trained in da Vinci minimally invasive surgical practices. Contact us to learn more about robotic surgery for the treatment of colorectal cancer.