Robotic colorectal surgery: what are the main benefits?

Nowadays, there are plentiful options when it comes to choosing what kind of surgery best suits a patient suffering from a bowel-related medical problem that requires surgical intervention, with laparoscopic (keyhole), traditional, and robotic surgery all on the menu to choose from.

In this informative article, esteemed gastrointestinal surgeon, Mr Charles Evans, details the main benefits of robotic colorectal surgery, outlines the potential complications, and also compares this surgical method to the more traditional, open surgery to treat bowel conditions.

What are the main benefits of robotic colorectal surgery?

By attaching robotic arms to the instruments that go inside the patient’s body, it allows me as a surgeon, firstly, to see in amazing 3D high definition, as I am looking at a 3D image that is just second to none.

I am then in control of some instruments that are not just your standard keyhole surgery ones that open and close, but they’ve actually got a wrist. It is like having mini hands inside the body. Having these hands there really allows the surgeon to control in a really precise way how they're operating.

In addition to that, not only does the surgeon have their left and right hands to operate with, but they also have an additional hand (acting as a second assisting hand) which allows the surgeon to set up the tissue that they are going to operate on with the one hand, and then have their two hands there to operate, so really, they have absolute control of where they are operating.

A lot of colorectal surgery is for bowel cancer, so you (as a surgeon) really want to ensure that you’re in the most precise plane and that you’re not leaving any of the tissue behind. I believe that doing this robotically allows us surgeons to be able to do this the best that we possibly can.

This advantage is also combined with the fact that because I’m doing it (performing the surgery) with these little instruments inside the body, I’m performing a keyhole operation. This means that the patient will recover a lot quicker than they would if I had performed the surgery in a more open-cut, traditional way.

With robotic colorectal surgery, the patients will only have small holes that won’t be too painful because the robotic arms are very stable on the stomach wall. This all means that my patients can be up and about, eating and drinking as soon as possible.

How exactly does it differ from normal, standard colorectal surgery?

Robotic surgery is basically keyhole surgery, and it allows surgeons to manoeuvre in and around tight spaces and bends in the human body, which is something traditional surgery cannot achieve as easily.

Traditional surgery also relies on a relatively inexperienced assistant, whereas, with robotic surgery, you can rely on an extra pair of hands so to speak, and so the surgeon can pretty much perform the surgery by themselves.

Also, with robotic surgery, I don’t suffer from the fatigue that I would suffer from if I were to perform traditional, non-robotic surgery. The trouble also with an open operation (traditional) is that, with a big cut, and with a lot of handling of the bowel, there is a higher chance that the patient will experience some complications in the recovery period, such as wound infections and the bowel taking longer to get going. These complications are greatly reduced with robotic surgery.

Are there any potential side effects or risks involved with robotic colorectal surgery?

Any big colon operation is a high-risk operation, and they all have potential complications. The main ones are as follows:

• bleeding
• damaged bits of bowel
• anastomotic leak

These risks, however, are greatly reduced when robotic colorectal surgery is performed,

Generally, how successful is this surgery?

The success is dependent on many factors, the patient itself being one of those, but also how good the patient’s surgeon is. Patients really need to pick their surgeons wisely. Overall, the success rate of robotic colorectal surgeon should be good if the surgeon has a good team who have practiced sufficiently using the robot. In terms of my team, when we’ve operated with the robot, we have certainly done a really good, precise job.

In terms of clinical recovery, you still get complications if you do it robotically, but the evidence that we have in our Trust is that the complication rates are slightly lower than they are when done laparoscopically or through open surgery.

Who is the ideal candidate for robotic colorectal surgery? Is there anyone who shouldn’t undergo it?

I think all patients are potentially ideal candidates for robotic surgery, as there is no reason why you can’t have your surgery done robotically for a colorectal problem. There really isn’t anyone who shouldn’t be an ideal candidate for it.

However, if you don’t believe in the robot, don’t feel comfortable with it, or simply do not trust your surgeon using it, then you shouldn’t be having a robotic operation.

Mr Charles Evans is a highly accomplished, expert gastrointestinal surgeon who specialises in conditions and surgical procedures related to the bowel. If you are considering undergoing a robotic surgical procedure to treat a bowel problem that you currently are suffering from, make sure you book a consultation with Mr Evans today via his Top Doctors profile.