Our Summary

The researchers in this study were looking at how the level of training of an assistant surgeon affects the outcomes of a specific type of surgery called robotic-assisted proctectomy (RAP), which is a procedure to remove rectal cancer. They looked back at data from all the patients who had this surgery between 2011 and 2020 and divided them into three groups: those who had assistant surgeons who were early in their training, those who had assistant surgeons who were more advanced in their training, and those who had fully trained, board-certified surgeons assisting.

They found that the level of training of the assistant surgeon didn’t really affect how long the surgery took. However, they did find that patients who had less experienced assistant surgeons had slightly more complications after surgery and stayed a bit longer in hospital. Even so, the differences between the groups were not significant for complications occurring during surgery, major complications after surgery, having to be readmitted to hospital within 30 days, or death.

In simple terms, the study suggests that having a less experienced assistant surgeon might lead to a few more problems after surgery and a slightly longer hospital stay, but it doesn’t seem to significantly affect the success of the surgery overall.

FAQs

  1. What is a robotic-assisted proctectomy (RAP)?
  2. Does the level of training of the assistant surgeon affect the duration of the surgery?
  3. Does the experience level of the assistant surgeon influence the post-surgical complications and the length of hospital stay?

Doctor’s Tip

One helpful tip a doctor might give a patient undergoing a proctectomy is to discuss with their surgeon the level of experience of the assistant surgeon who will be assisting in the surgery. While this study shows that the level of training of the assistant surgeon may have a small impact on post-surgery complications and hospital stay, it’s important for patients to be informed and involved in their care decisions. Patients can ask about the experience of the assistant surgeon, express any concerns they may have, and work with their healthcare team to ensure the best possible outcome for their surgery.

Suitable For

Patients who are typically recommended for proctectomy include those with rectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), anal cancer, familial adenomatous polyposis (FAP), or other conditions that affect the rectum. Additionally, patients who have not had success with other treatments for these conditions may also be recommended for proctectomy.

Timeline

Before proctectomy:

  • Patient is diagnosed with rectal cancer and undergoes various tests and consultations with healthcare providers.
  • Patient and healthcare team discuss treatment options, including surgery, chemotherapy, and radiation therapy.
  • Patient undergoes preoperative preparation, which may include bowel preparation, dietary changes, and cessation of certain medications.
  • Patient meets with the surgical team to discuss the specifics of the proctectomy procedure, potential risks and benefits, and postoperative care.

After proctectomy:

  • Patient undergoes the proctectomy procedure, which involves the removal of the rectum and possibly surrounding tissues.
  • Patient is monitored closely in the immediate postoperative period for complications such as bleeding, infection, and bowel obstruction.
  • Patient begins the recovery process, which may involve pain management, wound care, and physical therapy.
  • Patient is discharged from the hospital once stable and continues recovery at home.
  • Patient follows up with the surgical team for postoperative appointments and monitoring of recovery and potential complications.
  • Patient may undergo adjuvant treatments such as chemotherapy or radiation therapy as part of their cancer treatment plan.

What to Ask Your Doctor

Some questions a patient should ask their doctor about proctectomy include:

  1. What is the reason for recommending a proctectomy in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time following a proctectomy?
  4. Will I need any additional treatments or therapies after the surgery?
  5. How experienced is the surgical team that will be performing the proctectomy?
  6. Are there any alternative treatments or procedures that could be considered instead of a proctectomy?
  7. How often do you perform proctectomies, and what is your success rate?
  8. What can I do to prepare for the surgery and improve my outcomes?
  9. What will the follow-up care look like after the proctectomy?
  10. Are there any long-term side effects or considerations I should be aware of after the surgery?

Reference

Authors: Shiber M, Anteby R, Russell B, Zager Y, Gutman M, Nachmany I, Horesh N, Khaikin M. Journal: J Robot Surg. 2023 Jun;17(3):1097-1104. doi: 10.1007/s11701-022-01515-5. Epub 2022 Dec 31. PMID: 36586036