RoLaCaRT: Could using robots lead to more successful surgeries?

Using a robot rather than keyhole surgery could lead to a higher rate of successful surgeries for people with colon cancer.

The trial will recruit over 300 people with right-sided colon cancer. Almost half of cancer cases develop in the right-hand side of the colon, and these have lower survival rates than left-sided colon cancer.

Surgery for these cases of colon cancer was traditionally performed through open surgery, but laparoscopy (keyhole surgery) has been proven to have the same long-term survival outcomes as well as several advantages for the patient. These include shorter length of stay, less pain, early return of bowel function, early return to work, and less scarring and chance of hernias in the long term.

Professor Andrew Stevenson, Principal Investigator of the trial, believes that robotic surgery could improve these outcomes yet again.

“For the past seventeen years, robotic surgery has largely been one for treatment of prostate cancer,” he says. “Newer versions of the robot are allowing us to do more complex operations involving the bowel.”

This will be the first trial of its kind in the world. To accurately determine the benefits of robotic surgery compared to laparoscopy, Professor Stevenson and his team are using a new term, ‘successful surgery’. This will measure the number of patients who have surgery with no complications and are release from hospital quickly their cancer entirely removed.

“What we’re mainly looking at is the number of times that patients will have successful surgery if it’s done robotically compared to laparoscopically,” says Professor Stevenson. “We suspect that there may be a 15-20% difference between those two groups.”

One key factor that the trial will shine light on is whether the robots, which cost around $4 million, provide a benefit to patients. If there are found to be fewer complications or better outcomes for patients with robotic surgery, than this cost would be worthwhile.

The surgical operation performed for many patients with this type of colon cancer is a right hemicolectomy. Around 8,000 right hemicolectomies are performed each year.

“It’s important that the surgery – which is still the main way of treating colon cancer, to remove it – is as good as can be performed,” says Professor Stevenson.