Robotic Colorectal Surgery
Why is it innovative?
Most surgeries to treat colorectal cancer and other diseases of the colon and rectum are performed using open surgery (through a large abdominal incision) or laparoscopy (operating through small incisions using special instruments, including a probe with a camera at its tip). Surgeons have been refining robotic surgical approaches for colorectal operations. Robotic colorectal surgery is quite challenging, however, and requires specialized training and a high level of competence. NewYork-Presbyterians colorectal surgery teams include international leaders in the use of robotic surgery for select operations — including the first surgeon in the world to perform robotic rectal cancer surgery — and have performed more of these operations than many other centers around the country.
How you benefit
Compared with open surgery, people who have robotic colorectal surgery may benefit from:
- Smaller incisions with minimized scarring
- More precise surgery due to enhanced magnification of the surgical field and steadiness of the robot's instruments, offering the surgeon improved dexterity, easier suturing, and better ability to maneuver the instruments
- Less pain and discomfort after surgery
- A quicker recovery and return to normal activities
- Ability to begin postsurgical treatments sooner, such as chemotherapy for rectal cancer, which may improve cancer outcomes
Robotic surgery permits better access to the pelvic region than laparoscopy, making it a useful technique for surgery in certain hard-to-reach areas.
How does it work?
It is important to note that the robot does not perform the surgery; rather, the robotic system is a tool the surgeon uses to complete the operation. The surgical robot's arms are positioned where needed in the patient's abdomen through 4-6 small incisions. The surgeon sits comfortably at the robotic surgery console and is able to control the system’s instruments from there. The surgeon can remove a tumor or other diseased tissue or repair a rectal prolapse (where the rectum slides down through the anus) using the robotic tools.
Is it for me?
Robotic colorectal surgery has had the greatest success when used in the treatment of rectal cancer. Our surgeons assess it as an option for every patient who is eligible for laparoscopic surgery. You may be a candidate for robotic colorectal surgery if you have:
- Rectal prolapse
- A benign rectal tumor
- Certain tumors of the lower (sigmoid) colon
- Need for removal (resection) of the colon or rectum
- Parastomal hernia (a hernia that develops where an ostomy has been made after removal of the colon)
- Scar tissue in the belly (although some patients with excessive scar tissue may not be able to have robotic surgery)
- A large colorectal polyp
- Inflammatory bowel disease (ulcerative colitis or Crohn's disease)
What does the future hold?
Open colorectal surgery will always have a role in the care of some patients. But robotic surgery is an encouraging and evolving field, and its use has been growing steadily. As more data are collected on outcomes of patients having these procedures, more surgeons are trained in these complex techniques and have increased access to robotic surgery systems, and new instrumentation is developed, its applications will continue to expand.
Surgeons are hopeful that a newer single-port robotic surgical system will be useful for some colorectal surgeries, enabling them to perform the entire procedure through the anus and avoiding the need for any external incisions.