The role of robotic surgery in bowel cancer treatment

Robotic-assisted surgery is a minimally invasive approach to surgery which offers multiple beneficial clinical outcomes. For patients with bowel cancer (also known as colorectal cancer), robotic surgery can help during the excision of the cancerous tissue in the bowel.

Here, Mr Matthew Tutton, leading consultant general and colorectal surgeon, provides an expert insight into the function of robotic surgery in bowel cancer treatment, including how safe and effective robotic surgery is.

How is robotic surgery used for the treatment of bowel cancer?

There are very good options for treating bowel cancer. Robotic surgery is one of the newest modalities for treating bowel cancer surgically. Patients with bowel cancer will undergo several investigations during their diagnosis at which we look at their suitability for robotic surgery. This will usually include a colonoscopy and a CT scan or potentially an MRI scan to examine what part of the bowel or other organs the cancer involves.

The biggest advantage of robotic surgery is that it employs the most up-to-date, modern technology available. As a result, surgery becomes phenomenally precise, the optical views that can be obtained are in three dimensions (3D) and the equipment allows for greater control around major blood vessels and important structures. This hopefully translates into a better prognosis as we are able to remove all aspects of the tumour and its surrounding blood supply. Robotic surgery additionally provides excellent cosmetic results with lower risks of developing post-operative hernias.

Is robotic surgery safe?

Robotic surgery is one of the safest forms of surgery that can be performed. Besides using state-of-the-art technology, robotic surgery also requires all of the theatre staff, nursing staff and surgeons to complete specific advanced training programmes.

Robotic surgery has strict quality assurance processes and analysis of the techniques used. Video recordings and results from surgery are analysed in great detail.

Considering all of this, robotic surgery is one of the safest techniques for surgery that exists right now.

How effective is robotic surgery? What potential risks are involved?

With bowel cancer surgery, the evidence for robotic surgery is very good. In regards to my own practice, having performed laparoscopic surgery for bowel cancer for nearly 20 years now – of which the last couple of years were robotic surgery – I can compare the two approaches and know that my preferred choice is a robotic technique. Robotic surgery has been found to be a very safe surgical technique, allowing for better surgical control, excellent outcomes, slightly quicker recovery and improved pain control, meaning that patients are able to heal and return to normal life more quickly as well.

The main risks of robotic surgery are similar to the other surgical techniques. With bowel cancer surgery, the diseased bowel is removed and then other parts of the bowel are usually joined back together. If the body does not heal properly, then that part could leak and lead to complications that may need further surgery.

Is robotic surgery the best and most effective treatment option for bowel cancer?

Robotic surgery is still quite a novel technique in the UK; although some hospital units have been performing it for many years. Thus, it is an area of continued research, in which surgical outcomes between open, laparoscopic or robotic surgery are compared.

Every patient is also an individual and so all scans and imaging need to be reviewed to work out the best treatment for each patient. This could be a combination of surgery, chemotherapy or, for some patients, radiotherapy.

When robotic surgery is available, I personally find this provides the best opportunities and results, including safe surgery, minimum invasive surgery and a quick return to normal activity. Despite this, robotic surgery is still only one component of various surgical options. It is important to discuss and consider all options available before choosing one.

How many robotic surgery procedures are required to treat bowel cancer?

As a rule, most patients will only have one robotic operation performed. Some patients may need more than one operation, this can depend on the cancer site.

There are occasions, due to the risk of the join in the bowel not healing, where we use stomas on the tummy surface for some patients, to divert the stool away while healing occurs. This could mean an additional operation to reverse a temporary stoma. For the stoma itself, the reversal operation is not performed robotically.

If you have recently been diagnosed with bowel cancer and you wish to find more about how robotic surgery could help you, don’t hesitate to visit Mr Tutton’s Top Doctors profile today.