Robotic Surgery for Cancer Treatment

In general, robotic surgery is as safe as conventional surgery. It may even be safer than conventional surgery for extremely involved operations like the robotic Whipple procedure.

Many surgeons find that the robotic arm lets them increase the precision and control of their movements during surgery. The robotic system's high-definition, 3-D viewer also lets surgeons see the surgical site better than with conventional magnification.

You may also experience a smoother recovery with robotic surgery.

The benefits of robotic surgery can include:

• Smaller incisions
• Less scarring
• Reduced pain and blood loss
• Shortened hospital stays
• These benefits tend to be the most pronounced with complex cancer surgeries.

Possible robotic surgery risks include the following:

• Your surgeon may need to change to open surgery during the operation if he or she finds something unexpected that needs to be resolved through an open procedure.
• There is a small risk of bleeding, blood clots, infection, and other complications. These risks are the same regardless of whether a surgery uses robotic or conventional techniques.
• It may take as long as conventional surgery, especially with common procedures, because staff may need extra time to set up the robot for each surgery.

As an international leader in robotic surgery, UPMC offers robotic-assisted surgical treatments for every FDA-approved type of surgery, including:

• Colorectal. Robotic surgery is often ideal for treating colon cancer and rectal cancer, since these conditions typically require complex surgery.
• Gynecologic. UPMC's gynecological surgeons have vast experience in applying robotic surgery to a number of gynecological cancers.
• Head and neck. UPMC surgeons have developed new techniques using assistive robots to access hard-to-reach head and neck tumors. Surgeons can now reach many tumors through the natural mouth opening via transoral robotic surgery (TORS). This avoids the need for external incisions through the face and jaw.
• Pancreatic. UPMC is one of the world's most experienced centers for robotic Whipple surgery for pancreatic cancer. Our team also has expertise in robotic surgery for liver and bile duct cancers.
• Thoracic (Esophageal and Lung).At UPMC, we treat esophageal cancer, lung cancer, thymus, and other mediastinal (middle chest) tumors using minimally advanced invasive robotic surgery.
• Thyroid. When UPMC surgeons treat thyroid cancers with robotic surgery, the result is usually prompt healing with no visible scarring.
• Urologic (Prostate). At UPMC, robotic surgery has become a standard technique of urologic surgery for conditions like prostate cancer.

Your surgeon will give you specific guidance on how to prepare for your cancer surgery. The National Library of Medicine offers these general guidelines:

• Complete any necessary preoperative testing at least a week before your surgery date. These tests might include blood tests, urinalysis, urine culture, chest x-ray, EKG, and/or other diagnostic tests, as needed.
• Stop taking aspirin, blood thinners, and/or anti-inflammatory medicines 10 days before surgery. Your doctor will let you know if and when you should stop taking vitamins or other supplements.
• Your doctor may instruct you to use an enema, laxative, or colon preparation the day before surgery, depending on your specific operation.
• Stop eating and drinking at least eight hours before surgery. Your doctor may permit you to take medication with a sip of water (no coffee, tea, or juice) the morning of surgery. If you have diabetes, ask whether you should take your diabetes medications on the day of surgery.

At your preoperative visit, your doctor will give you information about where to park, when to arrive, and where to report on surgery day.

You'll want to leave all valuables at home, and wear loose, comfortable clothing.

Once you arrive at for your surgery, staff will take you to a preoperative area. A nurse will take your vital signs and help you into a hospital gown. You might receive your intravenous (IV) line.

An anesthesiologist will discuss your anesthesia options and receive your consent for surgery. You will most likely need general anesthesia. For some procedures, regional anesthesia with sedatives to calm you may be possible.

Once you're in the operating room, the anesthesiologist will start your anesthesia. You will not feel pain during the surgery.

During the operation, the surgeon will sit at a computer console near the operating table. This console provides a high-definition, 3-D view of the surgical site sent via a camera arm.

The surgeon operates by controlling the system's mechanical arms. Tiny surgical instruments extend from the mechanical arms.

Other team members will assist at the operating table as needed.

After your surgery, you will wake up in the hospital's recovery area. Your nurse will wheel you to a hospital room once you reach certain clinical milestones.

The course of your recovery will depend on many factors, like your type of cancer and specific surgery. Although robotic surgery often shortens hospital stays, expect to stay overnight in the hospital at minimum. Your doctor will let you know how long your hospital stay might last.

At every point, you have the right to ask questions about your care. You will make decisions in partnership with your doctor as your condition permits.