Professor MD MD hc Guido Schumacher
А colon is the longest part of the large intestine which also includes the cecum, rectum, and anal canal. Sometimes this word is referred to the entire large intestine. The colon consists of the three sections that are: the ascending colon, transverse colon, descending colon and sigmoid colon. Among the numerous disorders of the large intestine not all necessary require surgical treatment but when it comes to surgery a qualified team of surgeons of Clinic of Braunschweig can provide procedure performance at the highest professional and technological level. Along with traditional open surgery and conventional laparoscopic colon resection we offer the latest technique of robotic colon surgery.
There are different conditions of the colon that can require colon surgery but the most common are following:
You may also need emergency colon operation in case of injury and massive intestinal bleeding of unclear origin.
First robotic surgery was performed as far as in 1994 but it needed time for procedure to become routine treatment. Even implementation of da Vinci® robotic system in early years of 21th did not revolutionize the routine of colorectal surgery. Nevertheless, starting from 2003-2004 the number of robotic surgeries has been growing steadily. Nowadays, we have increasing number of reports on robotic surgery for colorectal diseases confirming that it is equally safe and effective as conventional surgery but has all benefits of minimally invasive surgery and some extra associated with usage of the robot.
Well-known advantages of laparoscopic surgery are:
Extra benefits of using the robot are:
The most of colorectal operations using da Vinci® system are total or partial colon resection (colectomy) with anterior approach. During colectomy a surgeon cuts diseased part of the bowel and sews the healthy ends together. With minimally invasive technique surgery is performed through the keyhole incision but when it is done by robotic machine the main difference that the surgeon does not manipulate with his/ her hands but control the process of operation seating in a chair in front of console. The only action the surgeon performs by hand is making the incisions for introducing a camera, probe and tools. Then, everything is done by the robot.
But do not fall into confusion. If it said machine does surgery it does not mean it is programmed or so. Nothing can be done without surgeon, the system only imitate each movement of the hands on the console, so everything depends on surgeon’s skill.
It was found that using robotic system perfectly suits for treatment of colon and rectal cancer, as well as bowel polyposis. It is known that in many cases intestinal polyps if untreated can develop into malignancy, so it is important to remove them even if benign as soon as they found.
Da Vinci® system allows removing all the cancerous and non-cancerous colon tumors with high accuracy preserving healthy parts of the bowel as much as possible. The robotic system is also unbeaten in accurate gathering of lymph nodes when surgery includes their removal.
Robotic surgery is comparatively often (11%) used for resection of sigmoid colon which is a small section of the large intestine next to rectum. After removal of the diseased part a procedure to connect healthy colon and rectum called anastomosis is performed. It is interesting that using of robotic system for sigmoid colon treatment is more popular in Asia as anatomically the sigmoid colon of Asian patients are longer that decrease risk of postoperative complication associated with mobilization of the colon.
Surgical invasion using the machine has nearly the same side effects as conventional colon surgery as:
One of the most important things when you consider on robotic surgery is surgeon skill. Only those who have great experience both in conventional and laparoscopic surgery can manage robot’s movements. Qualified specialists in colon surgery in Clinic of Braunschweig have high proficiency, years of experience and high motivation to works as a team to the patient’s benefit. If you need more information on the procedure or our colon surgeons’ qualification, please contact us.