Robotic surgery programme for abdominal tumours

The Candiolo Institute has become a centre of reference for robotic surgery, through its acquisition of the Da Vinci Xi Robot, representing the most advanced technological platform available in the field of  minimally invasive surgery.

Robotic surgery programme for abdominal tumours

 

The “added value” offered by the robotic approach to surgical operations is represented by:

• Computer-mediated vision, real three-dimensionality, magnification and extremely high definition of operative field images
• Reduction of movements on the part of the surgeon with elimination of physiological tremor
• Extension of rotation angles up to 360°, thanks to the fully-articulated instruments (an indicator of articulation can be expressed in terms of “degrees of freedom”: the human wrist can rotate with 4 degrees of freedom against the 7 of the Da Vinci Xi Robot).

Thus, the greatest “minimal invasiveness” is assured, with significant benefits in terms of: reduced surgical trauma; greater precision during the dissection of tissues; high levels of clinical-biological safety (lesser possibility of bleeding and infective complications); minimal scarring. Another of the Institute's strategic objectives is to gain accreditation as a training centre for robotic surgery. Robotic Surgery of Abdominal Tumours can be performed solely by surgeons expert in the field, and affords considerable advantages in various complex operations (in particular, on the stomach, colon-rectum, liver and pancreas). The Candiolo Institute's Robotic Surgery Programme for Abdominal Tumours is synergetic in its organization and research with the Programme for Hepato-Biliary-Pancreatic and Colo-Rectal Surgery.

 

The multidisciplinary approach

 

At the Institute of Candiolo all clinical cases are discussed collectively within Multidisciplinary Care Groups known as G.I.C.. The choice of robot-assisted surgery and the course of overall treatment are therefore assessed with the greatest care by a pool of professionals which guarantees the best therapeutic approach for each clinical case.

 

Fields of application

 

GASTRO-OESOPHAGEAL SURGERY

In the gastro-oesophageal area robotic surgery today represents tried and tested practice. The undisputed advantages for patients are now well-documented: reduction in post-operative complications – in particular in the respiratory tract, improvement in post-operative pain management, aesthetic advantage.

 

COLORECTAL SURGERY

Minimally-invasive robotic surgery has gained unanimous support in colorectal surgery , in particular in more complex procedures such as right hemicolectomy with CME  (Complete Mesocolic Excision) and central lymphadenectomy, splenic flexure resection,  resection of the rectum with TME. The data emerging demonstrate a better oncological resection quality, lymphadenectomy performed with more precision and a better functional outcome. The use of fluorescence with indocyanine green makes it possible to check the vitality of anastomosed tissues and,  with the aid of endoscopy, the definition of the lymph node map for a more radical and personalized removal of lymph nodes.

 

HEPATO-BILIARY-PANCREATIC SURGERY

Minimally-invasive surgery of the liver and of the pancreas is in constant and rapid expansion due to its proven advantages in terms both of short and long-term outcomes. This is rather complex surgery made easier, safer and standardizable through robotics.

 

SURGERY OF THE ABDOMINAL WALL

“Open abdomen” oncological surgery often results  in post-operative hernia at the site of the surgical incision. Robotics is revolutionizing the surgical treatment of incisional hernias thanks to a new technique known as “ component separation”, which ensures excellent results both in the short and long term. Candiolo IRCCS's mission indeed includes the care of patients with outcomes from  primary care such as the aforementioned incisional hernia, which constitutes, in any event, a damaging disease.

 

Translational research

 

A peculiarity of the Research Institutes for Hospitalization and Treatment (IRCCS) is the synergy between research and treatment which allows the immediate transferral into clinical practice of those new features developed in scientific studies underway at the time. In the field of  abdominal robotic surgery one such study on fluorescence-image guided lymphadenectomy in colorectal cancers is currently in progress.