71-year-Old Man with Low- Lying Rectal Cancer Treated via Robotic Sphincter-Saving Surgery at Fortis Mohali

By 121 News

Bhatinda, July 29, 2023:-The Department of Surgical Oncology, Fortis Cancer Institute at Fortis Hospital Mohali,has achieved yet another medical feat by successfully treating a 71-year-old mansuffering from low-lying rectal cancer via Robot-aided Sphincter-saving Surgery.The case attains significance as the Patient was spared a permanent Stoma Bag–a plastic bag that collects bowel movement from the digestive tract through an opening in the abdominal wall –usually required after surgery of the large and small intestine. The Stoma Bag is either temporary or permanent (if the cancer has affected the sphincter muscle, which controls defecation).

The Patienthad been experiencing bleeding from the rectum, changes in bowel habit and loss of appetite following which, he approached Dr Jitender Rohila, Consultant, Surgical Oncology and Robotic Surgeon, Fortis Hospital Mohali. Subsequent medical investigations such as Sigmoidoscopy, MRI scan and PET scan revealed that the Patient had Stage 3 low-lying rectal cancer. The biopsy pointed towards adenocarcinoma. Initially, the Patient was administered combined radiation therapy and chemotherapy (NACTRT) to shrink the tumour and prepare him for a sphincter-saving surgery. He was re-assessed after an MRI scan and a surgery was planned six weeks after the completion of NACTRT.Following discussions with the Tumour  Board, the team of doctors led by Dr Rohila conducted Robot-aided sphincter-saving surgery on the Patient, which lasted for around six hours.

Discussing the case, Dr Rohila, said that low-lying rectal cancer (within 5 cm from anal verge) surgery was a challenging task owing to its location within the pelvis and being adjacent to important organs,including the anal sphincter, which controls the passing of stools. This included theupper and middle rectum resection with removal of the local lymph nodes. After the tumour was removed, the ends of large intestine and anal canal were joined (anastomosis) avoiding a permanent stoma bag.Key-hole surgeries (laparoscopic and robotic) have been used extensively in rectal cancer (large intestine) surgeries across the world. Compared to open surgery, robot-aided surgery ensures less pain, less scars and faster recovery.

 

The Patientstarted walking on the next day of the surgeryand also resumed oral feed on Day 2. Hewas discharged five days after the surgery .The Patienthas completed hisadjuvant chemotherapy and is leading a normal life today.

On the latest robotic surgery system (Da Vinci Xi), Dr Rohila, added that Robot-aided Surgery is the latest form of minimal invasive surgery and provides a 3D view of the operative field via a special camera inserted into the body of the patient. Parts of the body which are difficult to reach with the human hand can be accessed through robot-assisted arms that can rotate 360 degrees and provide a wide range of movements. It allows a surgeon to preserve the anal sphincter (avoiding a permanent stoma bag), and nerves which supply the urogenital organs. This allows patients to have a good urinary and sexual function after the surgery.