07/08/2020
Minimally invasive da Vinci® robotic Colon Surgery...What’s the point?
There are many reasons a patient may need colon surgery. This can range anywhere from serious things like colon cancer to more benign issues like polyps or diverticulitis. Many times patients will end up in the emergency room and need emergent surgery that may limit their options. However the majority of patient will be seen for surgery based on something found during colonoscopy or on a CT scan or xray test. Once you have been diagnosed with a condition that requires part of your colon to be removed you have different surgical options.
If your doctor decides that a surgery is right for you, talk to your doctor about all of your options, including minimally invasive surgery. One option your surgeon may present is robotic-assisted surgery.
To help you make an informed decision, consider bringing questions like these to your surgeon or doctor visit:
~ What options are available for my colon surgery?
~ What is the difference between robotic-assisted surgery and laparoscopic surgery?
~ Is all minimally invasive surgery the same?
~ How big will the incision be where you remove my colon (extraction site)?
~ What type of anesthesia will I receive?
~ How long will surgery take?
~ Where will I have scars?
~ When will I go home?
~ How soon can I eat and return to normal activities after surgery?
In the past, surgeons made large incisions in the skin and muscle so that they could directly see and work on the area of concern. This is called open surgery. Today doctors still perform open surgery, but can also perform many colorectal procedures using minimally invasive laparoscopic or robotic-assisted surgery, possibly with da Vinci technology. Both minimally invasive surgical options require a few small incisions that doctors use to insert surgical equipment and a camera for viewing. In laparoscopic surgery, doctors use special long-handled tools to perform surgery while viewing magnified images from the laparoscope (camera) on a video screen.
If you and your surgeon decide that robotic-assisted surgery is right for you, your surgeon will use a 3D high-definition camera for a crystal-clear and magnified view.
Your surgeon will sit at a console next to you and operate through a few small incisions using tiny instruments, including a camera. Your surgeon fully controls all instruments. Every hand movement is translated by the da Vinci® System in real-time to bend and rotate the instruments for a precise surgical experience.
How is this different from laparoscopic surgery?
In all reality the robotic system is an advanced tool or instrument. Having this advanced tool lets surgeons perform the same operation in less invasive ways. A surgery to remove a segment of colon essentially requires two parts. First disconnecting the diseased segment meant to come out and second putting the healthy parts back together called the anastomoses. Traditional laparoscopic surgery instruments work well for the first part but still are not easy to use for the anastomoses and things like suturing. Because of this most laparoscopic colon surgery is done “laparoscopic assisted or hand assisted”. What this means is the surgeon still makes an incision large enough for his hand to fit in to help with the surgery. While smaller than traditional open surgery this is still a significant incision that can cause significant pain and delayed recovery time. The robotic instruments are 1 centimeter or less than ½ inch and can perform all movements a surgeons hand does making the entire surgery easier to perform without any large incisions. Because of this the only large incision that needs to be made is one large enough to remove the colon segment which is typically 3 centimeters or about an inch. Depending on the area of your colon that needs to be removed sometimes it can even be removed through a natural or***ce meaning no extraction site on the abdomen at all.
How might you feel after surgery?
Results vary, but if you are an appropriate candidate for minimally invasive surgery, robotic-assisted colon surgery may be a good option for you. That combined with the latest anesthesia and a multidisciplinary approach known as “Enhance Surgical Recovery (ESR)” can turn a surgery that used to be a week or more in the hospital into only a few days. Smaller incisions equal less pain and stress on your body and a quicker recovery. Most patients go home in a day or two taking a few Tylenol. Also part of the new ESR pathway means you will be drinking liquids immediately after surgery instead of starving for days post op. Once your bowels start working normally in a day or so after surgery you will be put on a soft diet and will be ready for discharge home.
If you or someone you know has been told they need a colon surgery, it is important to know what your options are and be informed. While not all patients may be a candidate for minimally invasive surgery if you are know that not all minimally invasive surgery is created equal. Take an active role and ask questions so you and your surgeon can both plan for the best outcomes.
If you have questions feel free to contact us for an appointment and more information to talk about robotic colon surgery.
