Robotic surgery in cancer
In cancer surgery, robotic surgery not only improves the removal of the organ concerned or the cancerous tissue: it also ensures complete removal of the lymph nodes.
The use of the robot in procedures for intra-abdominal cancer has increased markedly. Studies show that the robotic approach is a safe and beneficial method for radical oncological surgical procedures.
The advantages of the robotic system in cancer surgery
- It combines the advantages of open surgery and laparoscopic surgery
- The bowels resume activity more quickly
Types of cancer for which robotic surgery can be used:
- Thyroid tumours
- Stomach tumours
- Colon tumours
- Rectal tumours
- Liver tumours
- Pancreatic tumours
- Kidney tumours
Robotic surgery in diseases of the liver and bile ducts
Because of the position of the liver in the body, open surgical procedures on this organ require larger incisions; post-operative recovery is therefore affected and, despite this large incision, visibility remains limited during the operation. Today, many liver tumours can be removed easily by robotic surgery, without requiring a large incision and with better visibility.
In addition to a faster recovery and small incisions, the better visibility provided by the robot increases the precision of the procedure on the liver, making it possible to achieve better results with less bleeding.
The benefits of the robotic system in liver and bile duct surgery
- It combines the advantages of open surgery and laparoscopic surgery
- Better control of the cancer
- Less blood loss
- It reduces the risk of complications
- A lower infection rate
- Better visualisation of veins, lymph nodes and other structures during the procedure
- The bowels resume activity more quickly
- The patient starts eating by mouth again more quickly
- Less pain
- A shorter hospital stay
- A faster recovery to resume daily life
- Better cosmetic results (small incisions and fewer scars)
In which diseases can it be used?
- Removal of liver cysts and tumours
- Hepatectomy (removal of the right or left half of the liver, or of a smaller portion)
- Hepaticojejunostomy (creation of a connection between the bile ducts and the small intestine)
- Cholecystectomy (removal of the gallbladder)
Robotic surgery in diseases of the pancreas
Pancreatic surgery requires more technical specificity, not only because of the risk of bleeding from large veins but also because of the process of connecting the bile ducts, the intestines and the pancreas. Although the laparoscopic surgery used in pancreatic procedures provides greater comfort, factors such as the limited mobility of the instruments, the lack of ergonomics of the technique for the surgeon and two-dimensional vision make it necessary to modify the technical principles of open pancreatic surgery. The robot preserves the safety and effectiveness of open surgery while taking advantage of the benefits of the laparoscopic route.
The benefits of the robotic system in pancreatic surgery
- It combines the advantages of open surgery and laparoscopic surgery
- Better control of the cancer
- Less blood loss
- It reduces the risk of complications
- A lower infection rate
- Better visualisation of veins, lymph nodes and other structures during the procedure
- The bowels resume activity more quickly
- The patient starts eating by mouth again more quickly
- Less pain
- A shorter hospital stay
- A faster recovery to resume daily life
- Better cosmetic results (small incisions)
In which diseases can it be used?
- Distal pancreatectomy (removal of the elongated part of the pancreas)
- Whipple procedure (in cancer of the head of the pancreas: removal of the head of the pancreas, the end part of the stomach and the duodenum)
Robotic surgery in the treatment of diseases of the stomach and oesophagus
The benefits of the robotic system in surgery of the stomach and digestive tract
- Better control of the cancer
- Less blood loss
- It reduces the risk of complications
- A lower infection rate
- Better visualisation of veins, lymph nodes and other structures during the procedure
- The bowels resume activity more quickly
- Less pain
- A shorter hospital stay
- A faster recovery to resume daily life
- Better cosmetic results (small incisions)
In which diseases can it be used?
- Stomach cancer, benign tumours of the stomach, hiatus hernia, reflux surgery, Heller myotomy (achalasia), cancers of the digestive system.
- Transhiatal oesophagectomy, or removal of the oesophagus through the stomach or neck
- Transthoracic oesophagectomy, or removal of the oesophagus through the chest
- Benign tumours of the oesophagus
Research continues to show that, in the surgical treatment of stomach cancer, laparoscopic surgery gives results equivalent or superior to those of open surgery. Although the number of robotic lymph node removal procedures on the stomach in gastric cancer remains very small, the reported results show that the advantages of this method are clearly superior to those of procedures carried out by open or laparoscopic surgery.
- Laparoscopic surgery is a safe and effective method for hiatus hernia and reflux disease. As the results differ little from those of laparoscopic surgery, robotic surgery can also be applied to these procedures. It is also known that robotic surgery offers great comfort for complex procedures.
- Achalasia, which presents as narrowing and difficulty swallowing due to the failure of the muscles at the lower end of the digestive tube, that is, the region where it joins the stomach, to relax, is treated surgically by cutting these muscles.
- Thanks to its three-dimensional vision and great precision, this procedure can be performed more safely robotically than with laparoscopic and open techniques.
- Robotic surgery is also used in the treatment of benign tumours of the oesophagus and in the removal of diseased portions of the oesophagus in cancers of the digestive system. The abdominal and gastric portions of the oesophagus can be removed entirely using the robot without requiring a large incision; there is therefore less pain and fewer complications after the procedure, and the recovery is shorter.
Robotic surgery of the endocrine organs (thyroid and adrenal glands)
Axillary robotic surgery without gas insufflation is used as a simple, safe and effective treatment method in selected patients with thyroid cancer. It therefore does not leave, as conventional thyroid surgery does, a scar from an incision in the neck. However, this technique is not suitable for every patient; for example, obese patients, patients with a large thyroid, those whose thyroid extends towards the chest cavity and those with a short neck.
Robotic surgery in diseases of the adrenal glands
In the removal of adrenal tumours, laparoscopic surgery is considered the gold standard; however, thanks to the advantages of the robot, the limitations of laparoscopic surgery — two-dimensional vision and inadequate hand-held instruments — are also overcome. In addition to the general benefits of robotic surgery, its precision makes it possible to remove only the tumour while preserving the healthy tissue of the gland.
The benefits of the robotic system in adrenal surgery
- It combines the advantages of open surgery and laparoscopic surgery
- Better control of the cancer
- Less blood loss
- It reduces the risk of complications
- A lower rate of scar infection
- Better visualisation of the adrenal veins during the procedure
- The bowels resume activity more quickly
- The patient starts eating by mouth again more quickly
- Less pain
- A shorter hospital stay
- A faster recovery to resume daily life
- Better cosmetic results (small incisions and fewer scars)