Robotic Surgery For Colorectal Conditions

A Significant Advance in the Treatment of Colon and Rectal Conditions.

Even in today’s high-tech medical world, the words “robot” and “surgery” do not seem to fit together. But in fact, they do now. Thanks to recent advances in the field of robotics and mechanical programming technology, colorectal surgeons (formerly known as proctologists) are now able to seamlessly combine the use of high-tech robotic machines with minimally invasive operative procedures, by using small incisions, miniature wristed instruments and high definition, stereoscopic cameras. The procedure is then performed by the surgeon seated comfortably at a console, and a surgical first assistant at the patient’s side. The system is a passive system, moving only under the direct guidance of the surgeons. This a huge step forward in medical and surgical technology.

Why Robotic Technology?

In line with our guiding philosophy of delivering compassionate medical and surgical treatment while adhering to the highest principles in the art and science of medicine, the surgeons of Los Angeles Colon and Rectal Surgical Associates are using the da Vinci™ robotic surgical system in the operative treatment of colon and rectal tumors and certain other benign colorectal conditions such as rectal prolapse, enterocele repair and diverticulitis. Driving these decisions are results demonstrating that surgeons are able to deliver better surgical care and overall health care to patients when using robotic technology. Some of the specific advantages for patients who undergo minimally invasive procedures as compared to open procedures include:

  • Decreased need for postoperative pain medications
  • Shorter hospital stays
  • Quicker recovery and return to daily activities
  • Less postoperative pain.
  • Improved cosmetic results

Robotic-assisted procedures also aid in:

  • Better visualisation of the pelvic nerves that control continence (bowel and bladder control) and sexual functioning.
  • Decreased blood loss
  • Clinical results and cure rates similar to open and laparoscopic surgery
  • The potential to avoid the need for a permanent colostomy or ileostomy, as tumors can be removed from lower in the pelvis, allowing for sparing of the anorectal sphincter mechanism.
  • Procedures performed on obese patients and in males (as the male pelvis is generally more narrow than the female pelvis).

How Are These Results Achieved?

The da Vinci Si™ Robotic surgical technology provides patients and surgeons with advanced imaging and physical handling of tissues in order to increase precision and efficiency in the operative process. Technologies that we already have at our disposal can be manipulated and customized to better adhere to physical spaces inside the body, making it easier to merge this exciting technology within the confines of the human body. The robot is under the control of the surgeon at all times and allows the surgeon to perform in ways even more delicate than those of the human hand. These results are achieved using robotic-assisted technology and making use of all of the advantages of this technology. Some of these improvements are:

Imaging technology:

  • 3-Dimensional, stereoscopic high-definition field of vision
  • Instant image referencing
  • Fluorescent vascular imaging, to help in evaluating the blood supply to the operative area.

The da Vinci™ robotic system features high definition cameras used to magnify views during surgery, allowing for excitingly clear images of the operative site. Surgeons may reference CT images or ultrasound diagnostics taken prior to surgery alongside the real time view of the operative area.

Fluorescent vascular imaging applies intravenous indocyanine green coloring technology, administered during the operation, in evaluating the blood supply to the colorectal anastomosis (reconnection).

Human Mechanics:
The opportunity to increase a surgeon’s operational efficiency is also expanded with the use of other features of robotic technology:

  • An extra arm and mechanical wrists move with the surgeon during operations to keep attention forward-focused.
  • The arm can be applied to carry a retractor or other surgical instruments, providing 50 percent more operating capability to the surgeon.
  • The mechanical wrists may carry a variety of specialized instruments and operate similarly to a human wrist, but with a greater range of motion.
  • The surgeon can adjust the robot’s arm to travel a fraction of an inch for every inch the surgeon’s hand moves.
  • The most complex movements, including delicate resections, suturing and knot-tying become smooth and simple with the use of this technology.

Safety

Robotic technology, like laparoscopic technology and open surgical technology is as safe as the surgeon performing the procedure. It is important that surgeons using this technology be certified in its use. Safety may be enhanced through the improved optics and the precision of the movements of the surgical tools which are held in the “endo-wrists”. The results in cancer operations have been found to be similar to those found in laparoscopic operations.

Are You A Candidate for Robotic-Assisted Surgery?

Prior to undertaking any type of surgical treatment, an accurate diagnosis must be obtained. With this accomplished, your surgeons will be able to evaluate your specific set of findings in order to determine which type of treatment is necessary. Your surgeon will prepare you for the procedure. Your medical and surgical history will be evaluated and you will have a chance to ask questions about your upcoming operation. The final decision in the process is made during the operation, at which time the surgeons will evaluate your abdomen and decide upon the best surgical approach. In fact, most patients are candidates for robot-assisted procedures. Not uncommonly, several different approaches are combined to achieve the final result.

Changing The Future of Surgery, Today

As a result, robotic surgery has the potential to be transformational in certain surgical procedures. For example, in the resection of pelvic tumors, left sided colonic tumors and complicated resections or re-operative resections, robotic technology may be able to potentially lower the rate of pelvic nerve complications. Due to the confined space of the human pelvis, a surgeon is challenged with lower visibility and maneuverability in the operative field. Minimally invasive systems assist in overcoming space limitations and therefore increasing visibility and operability. The robotic-assisted solutions to the space conundrum may take operative interventions to unprecedented levels of accuracy.

The da Vinci Robotic™ Technology in Practice

The Surgeons of Los Angeles Colon and Rectal Associates are proud to use robotic surgical technology in their medical and surgical practice to continue to deliver the best possible medical care to its patients. Research covering minimally invasive procedures has shown clear benefits in applying this technology. Our LACRSA Surgeons, trained and certified to use robotics in their practice, are enthusiastic to adopt this remarkable technology in the treatment of colon and rectal tumors, in addition to certain benign colorectal conditions.

If you are interested in finding out more about this technology, contact our office to schedule an appointment with one of our colorectal surgeons.