Methodist Healthcare is home to the largest multi-specialty robotic surgery program in South Texas.
Lifestyle changes, dietary restrictions or certain prescription medicine for stomach pain can help resolve abdominal pain or other colorectal symptoms. If these options do not provide a solution, or if your medical condition is more advanced, da Vinci robotic surgery may be an option. The da Vinci System allows for minimally invasive, robotically assisted surgery that is completely controlled by your surgeon at all times. Robotic surgery offer several potential benefits compared to traditional surgery or laparoscopy including:
- Less pain
- Shorter hospital stay
- Lower blood loss
- Quicker return of bowel function
- Lower rate of complications
- Small incisions for minimal scarring
Conditions Treated with Robotic-Assisted Surgery
Minimally invasive techniques can be applied to most disorders of the colon and rectum. Below are some of the specific disorders that have been successfully treated with robotic-assisted surgery at Methodist Stone Oak Hospital:
- Abdominal and Pelvic Adhesions
- Crohn’s Disease
- Colon Polyps
- Colon and Rectal Cancer
- Pelvic Floor Disorders
- Rectal Prolapse
- Ulcerative Colitis
Abdominal and Pelvic Adhesions
Adhesions (abdominopelvic scar tissue) resulting from prior surgery can lead to abdominal pain, bloating and constipation. Sometimes, when symptoms are severe, surgery will be recommended. Robotic surgery can reduce the risk of recurring problems with adhesions because of precise surgical dissection, reduced tissue trauma and smaller incisions.
One of several diseases categorized as Inflammatory Bowel Disease (IBD), Crohn’s disease can affect any part of the gastrointestinal tract and affects all layers of the intestine. The primary treatment is medication. Surgery for Crohn’s disease should be avoided, if possible, due to the high risk of surgical complications and because there is no true surgical cure.
Unfortunately, surgery may be required for some Crohn’s patients. Typical indications for surgery include: intestinal stricture or fistula, bowel obstruction, bleeding, bowel perforation and weight loss. Surgery can usually be performed with minimally invasive techniques. Robotic surgery, specifically, can reduce the risk of postoperative adhesions, or scar tissue, which can complicate any future operations.
Polyps are small clusters of abnormal cells growing on the lining of the colon and rectum which can grow and ultimately lead to colorectal cancer. They are commonly diagnosed in people aged 40 and older and can usually be removed during colonoscopy. Colonoscopy is recommended for average-risk people beginning at age 50.
When polyps are too large, or located in challenging locations, they cannot be removed by colonoscopy. Robotic-assisted surgery can be employed in these cases to avoid an otherwise extensive removal of the colon or rectum. The polyps can be marked with special imaging modalities, removed from the large intestine, and the intestine repaired, all using minimally invasive techniques.
Colon and Rectal Cancer
Malignant tumors of the colon and rectum usually require surgical removal for effective treatment and cure. While some patients will be recommended for chemotherapy or radiation as part of the treatment plan, surgery will almost always be recommended. The importance of clear surgical margins and removal of potentially affected lymph nodes cannot be overstated.
There are several benefits of robotic surgery for patients who need surgery for colorectal cancer. Visualization with a high-definition 3D camera (specifically designed for robotic surgery) helps with identification of tumors and dissection planes to achieve clear margins. Colostomy can be avoided in many cases where it might otherwise be required. The number of lymph nodes removed with robotic-assisted surgery has been demonstrated to be higher than with other surgical techniques. Also, reduced recover time and decreased postoperative complication rates ensure that patients can begin other treatments (e.g., chemotherapy) without unnecessary delay.
Learn more about Colon and Rectal Cancer.
A diagnosis of diverticulitis indicated inflammation or infection in a portion of colon affected by diverticulosis. It can lead to further complications such as abscess, stricture, fistula, and colon perforation.
Uncomplicated diverticulitis usually responds to non-surgical treatment. When diverticular complications occur, surgery will likely be recommended. Robotic-assisted surgery allows for treatment of complicated diverticulitis through small incisions. Diverticular fistulas from the colon to the bladder, vagina or other segments of intestine can be easily corrected using minimally invasive techniques.
Learn more about Diverticulitis.
A very common diagnosis in the United States generally (and particularly in San Antonio), diverticulosis refers to the presence of small “pockets” protruding from the wall of the colon. It most commonly affects the sigmoid colon and can lead to abdominal symptoms such as pain, bloating and constipation.
Surgery is not commonly required for diverticulosis, but may be recommended when severe abdominal symptoms are present. Robotic-assisted surgery (to remove a portion of the affected bowel) can allow for a reduced hospitalization time and quicker recover compared to other surgical techniques.
Typically treated by Gynecologists and Infertility Specialists, endometriosis may require the involvement of a Colorectal Surgeon. Severe endometriosis can affect the colon or rectum and lead to pelvic pain associated with bowel movements or rectal bleeding during menses. When these symptoms occur, it may indicate that an endometrial tumor has invaded the intestinal wall and therefore requires removal. Endometrial tumors, or endometriomas, can be successfully removed from the intestinal wall with robotic- assisted surgical techniques and this can usually be accomplished at the same time as treatment for pelvic endometriosis.
Pelvic Floor Disorders
Pelvic Floor Disorders are complex, difficult to diagnose and can manifest with any of the following symptoms: painful or incomplete urination, urinary urgency or incontinence, pain or pressure in the vagina or rectum, fecal incontinence and incomplete rectal emptying or straining with defecation. Problems of the pelvic floor benefit most from a multi-disciplinary approach and patients may need to be evaluated by some of all of the following specialists: Gynecologist, Urologist, Urogynecologist, Colorectal Surgeon.
Surgery may play a role in treatment and can usually be performed with robotic-assisted techniques if the involved specialist surgeons are all accomplished in robotic surgery. Combined approaches achieve the best results and minimize the surgical and anesthetic risks.
Rectal prolapse results from a weakness of the normal attachments to the colon and rectum and can result in “telescoping” of the colon and rectum and sometimes prolapse of the rectum through the anal opening. This condition can be associated with constipation, diarrhea and disorders of the pelvic floor. However, once it develops, the treatment is usually surgical.
Robotic surgery can be used to perform a removal of the affected portion of the intestine and then sutures or mesh can be sued to perform a “lift” of the rectum to prevent this problem for recurring. Patients who require an operation usually feel immediate relieve and leave the hospital after one or two nights.
Another type of IBD, Ulcerative Colitis (UC) is characterized by inflammation and ulceration of the inner lining of the large intestine. Typical symptoms include pain, bleeding and diarrhea which can usually be controlled medically. Patients with UC are considered high-risk for colorectal cancer and should undergo more frequent screening procedures.
If surgery is recommended for US, the gold standard is an operation called Total Proctocolectomy with Ileal Pouch and Anal Anastomosis (J-pouch). This is considered a major abdominal procedure, but it can be performed using minimally invasive techniques. Robotic surgery on the da Vinci Xi platform with Table Motion technology can facilitate a safe, efficient operation and minimize complications.
Frequently Asked Questions and Answers
Methodist Stone Oak Hospital is home to the most experienced colorectal robotics surgeons and Operating Room team in the greater San Antonio area. The O.R. team, along with Dr. Lewis, have performed over 240 robotic colon-related procedures to date with exceptional outcomes.
Methodist Stone Oak Hospital utilizes the most advanced robotic surgical platform on the market, the da Vinci Xi system, and is the only facility in San Antonio with the cutting-edge Trumpf Medical specialty bed with Integrated Table Motion technology that allows for wireless communication between the da Vinci Xi robot and bed. This technology gives surgeons the ability to reposition the patient as needed, without interrupting the course of the operation.
Superior technology, experience and outstanding patient outcomes contribute to Methodist Stone Oak Hospital’s status as the only da Vinci Colorectal Mentor Site in South Texas. As a da Vinci Mentor Site, Dr. Lewis and his team host surgeons from all over the country who come to observe and learn.
Ask your doctor to refer you to a Colorectal Robotic Surgeon, choose a physician from Find a Doctor online or call Methodist Healthcare HealthLine at 210-575-0355. For questions regarding the Colorectal Robotic Surgery program at Methodist Stone Oak Hospital, email Tim Simecek, Director of Perioperative Services, at StoneOakRobotics@mhshealth.com. Your email will be answered within three business days.
Methodist Stone Oak Hospital is proud to be the only Robotic Colorectal Surgery Center of Excellence in South Texas.