What to Expect with Robotic Assisted Surgery

If you have small volume disease, your doctor may choose a minimally invasive approach for surgery. There are different ways to approach minimally invasive surgery. Some surgeons prefer traditional laparoscopic surgery where the surgeon is at your side working the instruments with their own hands. Others perform minimally invasive surgery using robotic assistance.

Robotic surgery involves the surgeon manipulating surgical instruments from a separate console, where as laparoscopic surgery involves surgeons using long, specialized instruments. Robotic surgery is simply a different way of conducting minimally invasive surgery.

The advantage with the robotic approach is increased dexterity as well as up to 20 times the magnification of the human eye. The surgeon makes several very small incisions — usually less than a centimeter each.   While it's not risk-free, robotic surgery has been shown to have a lower risk of complications and a shorter recovery time than open surgery.

Benefits of Robotic Assisted Debulking Surgery

"Robotic [assisted] laparoscopic surgery can be very helpful in ovarian cancer surgery," says Dr. Albert Pisani, gynecologic oncologist at Sutter Bay Medical Foundation in the Bay Area in California. "Some people get concerned that robotic surgery might not be as good as an open debulking surgery," he continues, "but for an early ovarian cancer, it's actually a very good approach."

While less appropriate for later stage and more aggressive cases, robotic surgery is particularly suited to staging and determining the spread of early stage ovarian cancer.

That's partially because of the high magnification that the laparoscope offers, allowing close visualization of the organs in the abdomen. According to Dr. Pisani, "the robotic laparoscopic approach gives you three-dimensional visualization." This means that "the surgeon sees the same thing that he or she would see with an open surgery, but magnified."

Along with the laparoscope, small tools are inserted into the body through entry points called trocars. Called "wristed" instruments because they mimic the movement of the human hand, these tools help the surgeon perform the debulking surgery in exactly the same way as they would in an open surgery.

While both minimally-invasive procedures result in less blood loss than traditional ovarian cancer surgery, the robotic surgery is considered more precise. The internal cameras used for the surgery magnify the view by about 20 times, and the robotic tools can access smaller spaces and stitch smaller sutures.

How Long Does the Surgery Take?

The length of time to perform robotic surgery for ovarian cancer varies, depending on what has to be done internally. For example, if the surgeon is removing a mass in the ovaries and determines that it is cancerous, they will then stage the cancer by determining whether it has spread to other organs. That involves taking biopsies of surrounding tissue such as the lymph nodes and the omentum, a “fatty apron” that hangs over the large intestine.

These biopsies take time, as they are all done through the same very small and delicate incisions. "It can take up to two or three hours," says Dr. Pisani, "but it's a very thorough approach."

How Long Does Recovery Take?

One of the biggest benefits to robotic-assisted surgery for ovarian cancer is the shorter recovery time. Recovery is typically a bit easier with robotic surgery than it is with others types of procedures and a lot of that has to do with the types of incisions being made during the surgery.

According to Dr. Pisani, "the recovery is generally about half the amount of time as it is for an open surgery."

A further benefit is that most people also experience less severe pain during recovery following robotic surgery. This means you are able to eat, drink, and move around much sooner; often on the same day or the day after the procedure.

Robotic surgery is an alternative to open surgery for some ovarian cancer treatments. While not appropriate for aggressive or later stage cancers, this minimally invasive approach can be helpful for early stage cancers, offering a shorter recovery time and a lower risk of complications.

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