Robotic cancer surgery

A diagnosis of cancer could hit one hard. That is why it is important to learn the facts about the condition and the best available options for treatment before choosing the way ahead.

The surgical treatment of cancers has traditionally been by open techniques. Open surgery is associated with a large wound and delayed recovery and return to normal activities. Laparoscopic surgery has been established as a feasible, safe and sound option for certain cancers including colon, endometrial, cervical and esophageal cancer but has limitations imposed by the 2-dimensional image, instruments with limited range of motion and dependence on a trained assistant for holding the camera.

Robotic surgery with the da Vinci System, on the other hand, bestows very high definition and magnified 3-dimensional vision with the camera controlled by the surgeon. The instruments with extreme degrees of freedom (Endo-wristed), enable the surgeon to use instruments in narrow confined spaces, to access difficult to reach cancers, and at angles that are impossible with open or laparoscopic instruments. Motion scaling which allows the surgeon to reduce the degree of instrument movement as a proportion of movement of the surgeon fingers, enables a greater degree of precision. All these provide the ultimate flexibility and precision for exceptional surgical techniques in cancer surgery.

In cancer surgery, robotic techniques enable a radical operation to be performed with preservation of nerves and other critical structures, due to better visualisation. This is particularly important in rectal, gynaecologic and prostate cancer surgeries. For example, in robotic prostate cancer surgery, every effort is made to spare the nerves. As the nerves and vessels are all magnified and it is much easier to save them and help retain potency.

Patient benefits include:

• Precise removal of cancerous tissue
• Significantly reduced pain
• Less blood loss
• Less scarring
• Shorter hospital stay
• Faster return to normal daily activities
• Equivalent cancer cure rates as open surgery

Practically all cancers are amenable to this approach with the exception of locally advanced tumours .Specific cancers where robotic surgery is able to provide excellent outcomes include:

• Colon and Rectal cancer
• Endometrial [Uterine] and cervical cancer
• Esophageal [Food pipe] and stomach cancer
• Early cases of pancreatic cancer
• Kidney, bladder and prostate cancer

Transoral Robotic Surgery (TORS): This is another type of minimally invasive surgery, specifically designed for patients with head and neck cancer. Here, the surgeon controls the robotic instruments that have been inserted through the mouth. No incisions are needed. In contrast, traditional open surgery requires long incisions through the throat and jaw, which often leave patients with visible scars, difficulty breathing or swallowing, and a lengthy recovery.

Trans Oral Robotic Surgery may be used to treat:

• Throat cancer
• Tongue cancer
• Tonsil cancer

Undoubtedly, robotic surgical techniques have revolutionized cancer surgery and improved survival and quality of life in cancer patients, giving them real hope that cancer is conquerable.