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What is robotic-assisted surgery?

One minimally invasive surgical option for patients with colorectal cancer is called robotic-assisted surgery, or RAS. In a robotic-assisted procedure, the surgeon controls a surgical system that helps with his or her precision and flexibility. As opposed to traditional open surgery where the surgeon makes a large incision to see and operate with handheld tools, robotic-assisted surgery allows for much smaller incisions. This is because the instruments are small and fit through an incision about the size of a dime. Therefore, the surgery is less invasive and often results in a shorter recovery time. 

Using this technology, surgeons can even see the entire procedure in 3-D and magnify their view to ten times its normal size. Throughout the entire process, the surgeon remains in control.

It’s important to know about your choices and to talk to your doctor about which option is best for you. Robotic-assisted surgery may be a good option for many because it can mean a quicker recovery and getting home sooner.

Who is eligible?

Many colon and rectal cancer patients are eligible for robotic-assisted surgery. The decision around which type of surgical procedure to use should be discussed with your doctor and healthcare team. Many patients also find it helpful to get a second opinion and discuss options with surgeons who have had experience with different types of techniques. The best type of surgery for you is dependent on many things, including your health, your surgeon’s experience, and your cancer type.

What can I expect during surgery?

In a robotic-assisted procedure, the surgeon uses several small abdominal incisions (about the size of a dime) to insert the surgical instruments into the abdominal cavity, as well as a long and thin lighted tube with a camera on the end. A larger incision, about 3-5 cm wide, is made to remove the tumor. The surgeon will remove the part of the colon or rectum with the tumor and nearby lymph nodes. 

During the procedure, your surgeon sits at a console next to you and operates using tiny, wristed instruments which translates every hand movement your surgeon makes in real time to bend and rotate the instruments with precision. Your surgeon may also use fluorescence imaging, which offers visualization beyond the human eye by activating injected dye to light up and clearly show the blood flow to the colon and rectum. This dye is safe to use and may help your surgeon during the procedure by improving visualization of the surgery site. Make sure to talk to your medical team about their robotics-assisted surgical experience and available surgery options.

What are the benefits and risks for patients?

Because it is a minimally invasive procedure, research shows that robotic-assisted surgery can lead to:

  • A shorter hospital stay 

  • A shorter overall recovery 

  • Fewer or similar rate of complications

What are the benefits and risks for surgeons?

Robotic-assisted procedures provide surgeons with high-quality computer images and more precise surgical instruments. This allows them to see the site well and accurately.

Minimally invasive robotic-assisted surgery also limits the amount and size of cuts used during a procedure. Many studies have shown that patient recovery is faster and easier with this technique compared to open surgical procedures. Robotic-assisted surgical procedures sometimes take longer to perform. Talk to your doctor about different costs and insurance implications.

Robotic-assisted surgery can also be beneficial for surgeons because it helps to overcome challenges associated with moving around the pelvis. 

Talk to your surgical team about what options work best for you.

What questions should I ask my doctor?

  • What options are available for my cancer? 

  • Which of those options are best suited for me and my needs? Why? 

  • What are the differences between types of surgery (open, laparoscopic, and robotic-assisted)?

  • How should I prepare for surgery?

  • What is your experience with this type and other types of surgery? 

  • What are typical outcomes for your patients? 

  • What should I expect in terms of recovery? 

  • What should I expect in terms of bowel function?

  • Are there any other long-term side effects I should be aware of?

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