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Robotic Surgery Treatment

The surgical treatment of cancers has traditionally been by open techniques. Laparoscopic surgery has slowly been established as a feasible, safe and oncologically sound option for certain cancers including colon, endometrial, cervical and esophageal cancers. Laparoscopy however has limitations imposed by the 2-dimensional image, instruments with limited range of motion and dependence on a trained assistant for holding the camera. The learning curve to attain expertise in laparoscopic cancer surgery is also very long.

Robotic surgery provides:
  • Very high definition magnified 3-dimensional vision with the camera controlled by the surgeon.
  • Instruments with extreme degrees of freedom (Endo-wristed), enabling the surgeon to use instruments in narrow confined spaces and at angles impossible with open or laparoscopic instruments.
  • Tremor filtration-removing physiologic tremor from manifesting as instrument movement.
  • Motion scaling which allows the surgeon to reduce the degree of instrument movement as a proportion of movement of the surgeon's fingers enabling a great degree of precision.

All these provide the ultimate in flexibility and precision for exceptional surgical technique. 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 and Gynaecologic Cancer surgeries.

Patient benefits include:
  • Significantly less pain
  • Less blood loss
  • Less scarring
  • Shorter hospital stay
  • Faster return to normal daily activities
  • Equivalent cancer specific outcomes as open surgery

What is important for the patient to note is that the surgeon, using the computer interface of the Robot to enhance his or her abilities performs the surgery and the Robot doesn't perform the surgery by itself.

Practically all cancers are amenable to this approach with the possible exception of locally advanced (T4 tumours).

Specific cancers where robotic surgery is able to provide excellent outcomes include:

  • Colon and Rectal cancer
  • Endometrial [Uterine] and Cervical Cancer
  • Oesophageal [Food pipe] and Stomach Cancer
  • Early cases of pancreatic cancer.
  • Kidney, Bladder and Prostate Cancer.

We now have the expertise at Apollo Chennai to treat the above cancers robotically with outcomes on par with the best centres. An important area where the use of the robot enables a better quality of surgery than the open or laparoscopic approach is for rectal cancer dissection. The robot has its maximum utility in the narrow confined pelvis of the male patient with a low rectal cancer especially after chemoradiation. A number of papers from the United States and Korea have shown better outcomes than laparoscopy in this group. Additionally in obese patients, the robot levels the playing field and enables the same quality of surgery to be performed as in a patient with a normal body weight.