By Prof Dato Dr. Tikfu Gee, Consultant Surgeon in General and Bariatric Surgery, Upper Gastrointestinal & Obesity Surgery, Weight Loss Surgery & Dr. Chong Hoong Yin, Consultant Surgeon in Colorectal, General and Robotic Surgery.

Based on GLOBOCAN 2020 statistics, colorectal cancer is ranked in the top five of the most common cancers in Indonesia for both men and women, which could stem from the reluctance to get a colonoscopy screening and make lifestyle changes.

Meanwhile, stomach cancer is the fourth most commonly diagnosed cancer after lung, colorectal, and breast cancers. It is also the second most common cause of death from cancer after lung cancer for the population of the Asia-Pacific region.

Based on WHO statistics, colorectal cancer ranks third while stomach cancer ranks fifth in the most common cancer types among new cases in 2020, with 1.93 million and 1.09 million cases, respectively. Naturally, they are also in the top five of the most common causes of cancer deaths in 2020.

The prevalence of robotics in stomach cancer surgery

It is estimated that about 70% of stomach cancers spread to lymph nodes, most of which are regional lymph nodes above the diaphragm. It is a daunting surgical disease as most patients come with an advanced stage of the disease, and the only curative treatment for this is the complete resection of the tumor with an extensive lymph node dissection.

Historically, this type of extensive surgery is extremely taxing to both the surgeons and the patients. Patients undergoing surgery will have a prolonged recovery period, requiring extended hospital stays and never-ending amounts of pain medications. However, currently with improving technologies and medical advancement, robotic stomach cancer surgery can minimize surgical trauma, hence reducing the side effects of the surgery on the patient. The main advantage is that robotic gastrectomy helps to ensure surgical precision while reducing postoperative complications and pain for the patient. Therefore, currently, robotic gastrectomy is considered optimal treatment for stomach cancer.

Minimizing surgical trauma is crucial to ensure long-term survival and good quality of life for stomach cancer patients. The patient’s early recovery from surgery with the ability to return to normal daily activities and to receive timely adjuvant treatment is an essential part of the comprehensive treatment for locally advanced stomach cancer. Robotic radical gastrectomy with its favorable outcomes is a promising option to expand the currently limited role of minimally invasive surgery for stomach cancer.

The number of robotic gastrectomy cases is increasing, especially in East Asia. Robotic gastrectomy was developed to overcome the current disadvantages of conventional laparoscopic surgery. The da Vinci Surgical System is the first and only robotic surgery system cleared by the U.S. Food and Drug Administration (FDA) in the year 2000. It is the gold standard worldwide to assist in the dissection and removal of the stomach during laparoscopic gastrectomy.

Robotic surgery is the way forward for colorectal cancer

Colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women. There were over 1.8 million new cases in 2018. The top 25 countries with the highest rates of colorectal cancer in 2018 are given in the tables below.

Robotic surgery for colorectal cancer has several advantages over conventional surgery in performing precise dissection. It provides the surgeon with a three-dimensional surgical view, eliminates instrument tremor, and reduces movement of the robotic interface.

A colon or rectum resection is a surgical procedure to remove either part of or the entire colon or rectum. It may be performed to treat both benign or malignant conditions:

  • Diverticular disease
  • Inflammatory bowel disease
  • Gastrointestinal bleeding
  • Intestinal obstruction
  • Colonic polyps
  • Colorectal cancer

Traditionally, the resection is done via open surgery, where a big midline incision is made to provide access for the surgeon to operate.

A minimally invasive approach to robotic surgery

The da Vinci Surgical System is the most advanced minimally invasive surgical system for resection of early-stage stomach cancer and colorectal cancer. The da Vinci Surgical System for gastrectomy and colectomy allows surgeons to remove cancerous tumors and lymph nodes in a more controlled, precise manner as compared to conventional laparoscopic gastrectomy. With the 3-dimensional da Vinci robotic surgical system, surgeons have virtually unlimited movement in all directions. And because the system provides 3-dimensional high-definition imaging, doctors can assess the surgical area and perform procedures with greater accuracy.

The benefits of robotic surgery include lesser blood loss, lesser pain postoperatively, shorter hospital stays and recovery, quicker return of bowel function and normal diet, and small incisions for minimal scarring. Other benefits include precise removal of cancerous tissue and faster return of urinary and sexual functions.

For the convenience of their international patients in Indonesia, SunMed has Representative Offices located in major cities in Indonesia; Jakarta, Surabaya, Bandung, Medan, Palembang, Padang, PekanBaru, Makassar and Semarang.

JakartaJl. Adiaksa No. 31 RT.7/RW.7 Pondok Labu. Cilandak
Jakarta Selatan 12440
SurabayaJln. Ir Soekarno Hatta 56-56 Surabaya 6011503199011103
BandungPaskal Hyper Square B-28 Jl. Pasir Kaliki 25 -27, Bandung Jawa Barat, 4018102286061075
PadangJln HOS Cokroaminoto No. 101, Padang 22118+628136348858
PalembangJl. Residen H.A. Rozak No.43A RT.02 RW.01 Kel. Bukit Bangkal Ket.
SemarangJl Indraprasta No. 2A Semarang 50131 Jawa Tengah,
MakassarJl Sungai Saddang, Latanette Plaza F no.8-9, Makassar 90114, Indonesia+624113623252
MedanJl Ahmad Yani, No.106, Medan, Sumatera,