While doctors still perform traditional open surgery—where a surgeon operates with handheld instruments through a single large incision in the abdomen—laparoscopic surgery and robotic-assisted surgery are less invasive options for many patients.
“For most colon cancers that are caught early, they can be addressed in a minimally invasive fashion,” says Dr. Clark. “While Laparoscopic surgery and robotic-assisted surgery are different operations, they’re quite similar in that the goal is the same, which is to restore people’s health and to give them the best survival.”
Laparoscopy uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through a small incision in the abdominal wall and the surgeon uses special long-handled tools to perform surgery at the patient’s side, while viewing magnified images from the laparoscope on a video screen.
During robotic-assisted surgery, a surgeon directs and controls the surgical instruments while seated at a console. This robotic technology is called the da Vinci XI surgical system. It features a magnified 3d high-definition camera and tiny wristed instruments that bend and rotate far greater than the human wrist, enabling surgeons to operate with enhanced vision, precision, and dexterity.
“It allows you to see around structures in the body more easily. That improves our ability to dissect safely and carefully and to make quick progress,” Dr. Clark says.
Through a simulation, Dr. Clark demonstrates how she can maneuver the surgical tools through just a few small incisions, which is easier on the patient and more ergonomic for the surgeon.
“The way that the surgeon sits and controls things feels much more like sitting down at a desk and working on a computer, or working a Rubix cube close to your body rather than reaching and pushing and pulling. The robot does a lot of that work for you.”
The surgeon is 100% in control of the da Vinci System at all times, and the system cannot be programmed or perform in any way without the surgeon’s input.
“It’s the trained surgeon who is guiding the robot and it is the surgeon who is making the decisions and is tailoring it all to the patient, says Dr. Clark.”
Benefits to the patient
Studies show these less invasive surgical procedures significantly reduce the time a patient must stay in the hospital after surgery and lead to reduced pain and improved recovery time—patients are often back to their daily routines within a couple weeks, instead of six to eight weeks with traditional surgery.
Not everyone is a candidate for laparoscopic or robot-assisted surgery, including those who have extensive scar tissue from previous procedures or have another underlying medical condition. Open surgery is often the safest procedure for patients in emergency situations. Dr. Clark encourages patients to trust their surgeon regarding the type of surgery that is best for them and their condition.
Catching colorectal cancer early
Colorectal cancer patients are more likely to be candidates for laparoscopic and robot-assisted surgery when their cancer is caught early. Symptoms may vary, depending on the cancer’s size and location, but may include:
- A change in bowel habits, such as diarrhea, constipation or narrowing of the stool, that lasts for more than a few days
- A feeling that you need to have a bowel movement that is not relieved by doing so
- Rectal bleeding
- Dark stools or blood in the stool
- Cramping or abdominal pain
- Weakness and fatigue
- Unintended weight loss
Colonoscopy is recommended beginning at age 50, or younger if you have a family history or are experiencing symptoms. Dr. Clark encourages people not to put off screening.
“It’s such an opportunity to not just diagnose colon cancer but to prevent these cancers from occurring in the first place,” she says. “And we have wonderful gastroenterologists in our community who do a great job screening patients. It’s a positive thing to do and a positive way to protect your health.”