Dr Jagdish Kothari, Senior Surgical Oncologist, HCG Cancer Hospital, Ahmedabad

Colorectal cancer is an umbrella term used for cancers that develop in the large intestine, namely in the colon, rectal and bowel areas and is triggered by adenomatous (precancerous) polyps that develop over time. This is a common type of cancer in the GI tract and Colorectal cancer is the third-most common type of cancer found among men in India and across the globe. This is common amongst both men and women as colorectal cancer is associated to a family history of colon or rectal cancer, as well as diet, alcohol intake, smoking, and inflammatory bowel disease. The symptoms of this type of cancer are difficult to diagnose in its earlier stages. However, upon diagnosis and to ensure faster recovery, physicians often take multi-modality approaches including surgery, chemotherapy and radiation therapy to treat.

Surgery is often opted to treat colorectal cancer wherein the diseased tumour, health tissues and lymph nodes are removed to ensure that the growth of cancerous cells are ceased. These surgeries, if performed in the traditional way, can be painful and result in extended hospital stay and delayed recovery. With technology and innovations in medical science, traditional surgeries are now being replaced with minimally invasive surgeries, the scope of which has expanded in the recent times, prompting surgeons to adapt the method to ensure faster recovery of the patient.

A step ahead of Laparoscopic Surgery

Laparoscopic or key hole surgeries, a type of minimally invasive surgery, in spite of its multiple benefits and advantages, do have limitations in terms of the camera being operator dependent, providing two-dimensional images and limited area for the surgeon to make movements. In contrast, robot-assisted surgeries offer 10X magnified view of the affected area, and three-dimensional views and the innovative ergonomic based surgery console can help reduce the fatigue faced by the surgeons while enjoying the freedom to make changes in the movement of surgical instruments as required. Robotic surgeries, basically, replicates hand movements during surgeries with precision. They also integrate the post-surgery faster recovery care plan to enable patients to stay at the hospital for a shorter duration, undergo minimal post-operative pain, reduced blood loss and better cosmetic results.

Surgical treatment of colorectal cancer requires meticulous and precise dissection of the lymph nodes around the infected organs. With time, the technicalities of the surgical procedure have evolved since the first colorectal surgery performed in 2001, and now provides better ergonomic designs and technologies to operate on difficult to reach places in the pelvic cavity.

Advantages of Robotic Surgery

In case of robotic surgery for colorectal cancer, high-definition three-dimensional imaging help the surgeon get a magnified view of the target organ and the tissues.

Robotic surgery has a several benefits for patients, which includes:

• Shorter hospitalization

• Reduced pain and discomfort

• Faster recovery time and return to normal activities

• Smaller incisions, resulting in reduced risk of infection

• Reduced blood loss and transfusions

• Minimal scarring

It also saves the patients from suffering a surgical trauma caused due to tear and bleeding of the minute and fragile tissue during a traditional or laparoscopic surgery as the robotic arms hold these tissues without causing any damage. These real-time achievements during robotic surgery contributes largely in improving the safety of the patients and oncological curability

Robotic surgery for colorectal cancer is now accepted as a promising, feasible and safe alternative surgical approach for its treatment. Using their thorough understanding and prior surgical knowledge and skillsets of following oncologic techniques to remove cancerous growthofthe large intestine and pelvic cavity, surgeons now opt for robotic surgery based on the condition of the patient, stage of cancer diagnosed and immediate symptoms for improved functional outcomes, long-term survival and better quality of life. As the technique will continue to evolve and innovate, the treatment of such types of cancers will continue to get redefined.