Chapters Transcript Video Robotic Colorectal Surgery Q&A Colorectal surgeon Chady Atallah discusses the uses and benefits of novel robotic technology for colon and rectal surgery. mhm. It is a new sophisticated tool that has just added to the arsenal of surgeries that we do for a million invasive surgery. The platform includes a patient card as well as a surgeon console and the patient card is actually what comes in within the sterile field above the patient and it has the four robotic arms. And through those robotic arms we use several types of instruments and staplers to perform the operation. The surgeon will typically sit at the surgeon console, which is in the operating room but away from the patient and through that console, the surgeon will have full control over the robotic arms. And at the same time there's a bedside assist which is either a resident or the physician assistant who has scrubbed in and helps move the instruments exchanged the instruments as well as introduce some laparoscopic instruments through an assistant port. That person also helps convert to an open operation in case that is needed in an emergency setting. Yeah. In the recent years, colorectal surgeons have introduced robotic technology into their operating room for several reasons. First of all, the robot adds a three dimensional view uh to the surgical field, which is something that you don't see in typical laproscopic surgery. Uh the other benefit of the robot is that the instruments have a 360 degree of motion at the level of the risk of the instruments and that is a little bit different than laproscopic surgery. It actually has a greater range of motion compared to laproscopic surgery and that improves dexterity and improves precision in the operating room. Uh Colorectal surgeons have really benefited from this technology, especially in pelvic operations and then during rectal dissection because the robot allows the camera and the instruments to get all the way beyond the cycle, preparatory and the curve of the sacrum all the way down into the pelvic planes. And we can actually dissect the rectum all the way down to the pelvic floor, into the anal canal. Using that uh that technology. The other benefit of the robot is that it has the ability to uh do intra corporeal anastomosis as opposed to the typical extracorporeal anastomosis that we perform laparoscopic surgery. And the reason why this benefits uh the patients is that when you do a trick report anastomosis, especially for right side collect amis, you don't need to mobilize the entire uh transports colon. And so that decreases the manipulation of the bow and the tension that is put on the mesen terry. And theoretically that decreases the risk of an alias post off. This is specifically true in obese patients where uh if you are doing an extracorporeal anastomosis, you have to make sure that the bowel and the colon reaches all the way up to the abdominal wall into the skin level. Before you can do the anastomosis, any patient who is a candidate for minimally invasive surgery or laparoscopic surgery is also a candidate for robotic surgery. In fact, we use the robotic technology in patients with cancer, whether it's colon cancer or rectal cancer or even anal cancer. We also use it in patients with IBD and Crohn's disease ulcerative colitis. But we also use it in patients with benign disease. Like diverticulitis. We actually know and we have data that shows that this technology just like laparoscopic surgery compared to open uh surgeries will decrease the length of stay uh and may also be associated with less pain post operatively and all that Without compromising the surgical outcomes that we have with open surgery. Specifically in cancer cases. We know that short term and long term uncle logic, outcomes and survival is not affected with the use of this technology. Mm mm hmm. I think this technology has allowed us to push the limit on what we can do with minimal invasive surgery. And we can in fact, now do these operations on patients who otherwise would have required a big, large open incision. I think that there's a lot of new companies that are coming up with platforms with robotic platforms. And so this technology is here to stay. Our group here at Hopkins are colorectal group is very aggressive and using the robot. And we have pretty much embraced this new technology to a point that now this is our go to uh, technique when we're looking to performing the invasive surgery. No. Created by Related Presenters Chady Atallah, MD Assistant Professor of Surgery View full profile
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