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There are three types of surgery for colorectal cancer.
First, open surgery
Open surgery is a surgical procedure that is performed by making an incision in the abdomen and opening it, and it is the most traditional type of surgery. Historically proven safety and effectiveness. However, the disadvantages of open surgery are that the wound and pain are large, and the recovery period is long.
Second, laparoscopic surgery
Laparoscopic surgery is a surgical procedure that has been performed for about 30~40 years, and it involves making three or four holes in the abdominal cavity and inserting a camera into the holes. The wound is small and painful, so it is a surgical method that compensates for the shortcomings of open surgery.
Third, Robotic SurgeryRobotic
surgery is performed with a robot that acts as an avatar of the surgeon. It is performed by a doctor who puts his face in a machine called a console and watches a screen that transmits the image taken by the camera. There are two types of robotic surgery: the multiport method, which is a traditional and standard method of making multiple holes, and the single-port method, which minimizes incisions.
There is a misconception about robotic surgery that it has the highest cure rate among surgical methods. However, this has not been proven. However, there are certain patient groups that may benefit from improving the cancer cure rate. For example, surgery for rectal cancer located close to the anus or lymph node metastasis* on the outside of the pelvis.
There is also a perception that robotic surgery is the best colorectal cancer surgery. The best cancer surgery is minimally invasive surgery that doesn't compromise the goal of removing the cancer. Open, laparoscopic, and robotic surgery each have their own pros and cons, and the best surgery may vary from patient to patient based on their previous goals.
*Kwakchotomy: A surgical procedure that extensively excuses lymph nodes around the cancer
Even if you don't have insurance, robotic surgery is recommended when you can clearly expect benefits in terms of curing cancer.
During robotic surgery, there may be a switch to laparotomy. Intra-abdominal adhesions are more severe than expected, severe bleeding during robotic surgery, or tumors that are too large for robotic surgical instruments to invade surrounding organs. However, in recent years, with the development of robotic technology, the rate of conversion to open surgery has decreased significantly.
Laparoscopy accounts for 7~80% of all colorectal cancer surgeries, and the rest are mostly robotic surgeries, and open surgery is performed in a small number of cases. In the case of emergency surgery, the rate of open surgery is much higher. In recent years, the proportion of robotic surgery has been increasing, and in the case of rectal cancer, which has a good prognosis of robotic surgery, robotic surgery accounts for about 3-40%.
In terms of surgical sophistication, laparoscopic or robotic surgery is superior to open surgery. This is because the screen is more accurate when transmitted by a 4K camera than the human eye, and in the case of robotic surgery, the angle at which the human hand moves is larger and more subtle.
Open surgery is usually the longest (5-7 days), and laparoscopic or robotic surgery usually requires a hospital stay of 3~4 days.
It depends on the skill level of the surgeon performing the operation. If the surgery is based on the principles of cancer surgery, it can be said that there is no difference.
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