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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 allows them to operate with a greater range of motion, and more precision than they would typically have with the human hand. 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 incisions about the size of a dime. This means that the surgery is less invasive. 

Using this technology, surgeons can see the procedure in 3-D and magnify their view to ten times its normal size. Throughout the 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 because it can mean getting home sooner, compared to open surgery.

Who is eligible?

Many colon and rectal cancer patients are eligible for robotic-assisted surgery. The best type of surgery for you is dependent on many factors, including your health, your cancer type, and your surgeon’s experience. The decision around type of surgical procedure 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 are experienced in different techniques. 

Robotic Assisted Surgery

What can I expect during surgery?

In a robotic-assisted procedure, the surgeon uses a few small abdominal incisions (each 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 may be made to remove the diseased tissue. The surgeon will remove a part or all of the colon or rectum with the cancerous tissue and possibly nearby lymph nodes.  

During the procedure, your surgeon sits at a console next to you and operates using tiny, wristed instruments which translate 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. This dye may help your surgeon to see during the procedure. Make sure to talk to your medical team about their robotic-assisted surgical experience.

What are the benefits and risks for patients?

There may be benefits to robotic-assisted surgery compared to open surgery for rectal resection procedures including:

  • Shorter hospital stay
  • Less blood loss during surgery
  • Lower or similar  rate of cancer cells remaining after surgery (called “positive surgical margin”)
  • Similar rate of survival during surgery or within 30 days of surgery

There may also be benefits to robotic-assisted surgery compared to open surgery for colectomy procedures including:

  • Shorter hospital stays
  • Lower or similar rate of complications, including blood transfusions, after surgery
  • Similar rate of reoperation within 30 days of surgery
  • Similar rate of readmission to the hospital within 30 days of surgery 
  • Lower or similar rate of survival during surgery or within 30 days of surgery

Like all surgery, there are risks to minimally invasive, robotic-assisted colorectal surgery. These risks include infection, bleeding, and bowel leakage. Robotic-assisted surgery may be associated with longer operative times compared to open surgery for both colon (colectomy) and rectal procedures (low anterior resection).

Each person handles surgery differently and your outcomes may depend on a number of factors, like health history, the type of colorectal cancer you have, and/or your surgeon's experience.

For references on the above the benefits and risks, please contact our Helpline at 877-422-2030. Talk to your surgical team about what options may be best for you.

What questions should I ask my doctor?

Here are some questions to ask your 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 each type 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? 

The robotic-assisted surgical outcomes referenced were studied using da Vinci surgical systems. 

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