Role of Robotic surgery in the management of hepatobiliary and pancreatic cancers

Role of Robotic surgery in the management of hepatobiliary and pancreatic cancersDr Surender Kumar Dabas, Vice Chairman – Oncology, BLK-Max Super Speciality Hospital, New Delhi

Hepatobiliary and pancreatic cancers are cancers involving the liver , gallbladder, bile ducts and its branches and pancreas. Robotic surgery has emerged as a transformative technology in the field of hepatobiliary and pancreatic cancers, revolutionizing the way these complex surgeries are performed. The integration of robotics into surgical procedures has significantly impacted patient outcomes, offering advantages such as enhanced precision, improved visualization, and reduced invasiveness.

In hepatobiliary and pancreatic surgeries, the intricate anatomy and proximity to vital structures pose challenges to traditional open surgeries. Over the years of surgical evolution, open surgery has largely been replaced by minimally invasive surgery, laparoscopic to begin with and now recent transition to robotic surgery. This is more so true in the management of complex hepatobiliary and pancreatic tumours. The introduction of robotics at the end of last millennium has helped overcome the shortcomings of laparoscopic surgery due to its inherent 3D HD vision, 7 degrees of freedom, more precision and control, meticulous dissection, better ergonomics, improved dexterity, endowrist movements, 10X magnification and greater instrument stability. This allows for more precise dissection and reconstruction, minimizing damage to surrounding tissues and organs.

One key benefit of robotic surgery in hepatobiliary and pancreatic cancers is its minimally invasive nature. Traditional open surgeries often involve large incisions, leading to prolonged recovery times and increased postoperative pain. Robotic-assisted procedures utilize smaller keyhole incisions, resulting in reduced blood loss, shorter hospital stays, and quicker recovery for patients.

The robotic platform’s ability to facilitate complex manoeuvres in confined spaces is particularly advantageous in hepatobiliary and pancreatic surgeries. Surgeons can navigate intricate anatomical structures with greater ease, ensuring meticulous removal of tumours and precise reconstruction of vessels and ducts. This level of precision contributes to improved oncological outcomes and a lower risk of complications.

Furthermore, the enhanced visualization offered by robotic systems is invaluable in identifying and sparing critical structures, such as major blood vessels and the bile ducts during surgery. This can be crucial in preserving organ function and minimizing postoperative complications.

The role of robotic surgery extends beyond the operating room. Telesurgery, enabled by advanced robotic systems, allows experienced surgeons to remotely guide less-experienced colleagues through complex procedures. This facilitates knowledge transfer and expands access to specialized surgical expertise, especially in regions with limited resources.

Despite the numerous advantages, challenges remain in the widespread adoption of robotic surgery for hepatobiliary and pancreatic cancers. The initial cost of acquiring robotic systems and the need for specialized training are factors that healthcare institutions must consider. Additionally, ongoing research is essential to continually assess the long-term outcomes and cost-effectiveness of robotic-assisted procedures in comparison to traditional approaches.

In conclusion, robotic surgery has significantly influenced the management of hepatobiliary and pancreatic cancers, offering improved precision, reduced invasiveness, and enhanced patient outcomes. As technology continues to advance and experience with robotic systems grows, the role of robotics in these complex surgeries is likely to expand, further shaping the future of surgical oncology.

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