Our Summary

This study looked at how using robotic surgery on obese patients might be more complicated than with non-obese patients. The researchers analyzed videos of 39 robotic surgeries that removed a part of the rectum (proctectomies). They divided these surgeries into specific steps and compared how the surgery went for obese and non-obese patients.

They found that surgeries on obese patients tended to involve more arm movements, longer paths for the camera, and longer times to complete each step. These factors could make the surgery more challenging for the surgeon. This is the first time a study has used objective measures to connect a patient’s physical characteristics (like obesity) with how the surgeon and the robot perform the surgery.

FAQs

  1. What was the purpose of the study on robotic surgeries for proctectomy?
  2. What were the findings of the study regarding the performance of robotic surgery on obese patients compared to non-obese patients?
  3. How does a patient’s physical characteristic, like obesity, affect the performance of the surgeon and the robot during a proctectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about proctectomy is to maintain a healthy weight before and after the surgery to help reduce the potential challenges for the surgeon during the procedure. This could include following a balanced diet, staying active, and working with a healthcare provider to manage weight effectively. Additionally, following post-operative care instructions carefully and attending follow-up appointments is crucial for a successful recovery.

Suitable For

Patients who are recommended proctectomy typically have conditions such as rectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), familial adenomatous polyposis (FAP), or radiation proctitis. These conditions can lead to severe symptoms and complications that may require surgical removal of part or all of the rectum. Obese patients may also be recommended for proctectomy, but as the study mentioned, their surgery may be more challenging due to their physical characteristics.

Timeline

Before proctectomy:

  1. Patient consults with a surgeon to discuss the need for a proctectomy and the potential risks and benefits.
  2. Patient undergoes pre-operative testing and preparation, which may include blood tests, imaging scans, and bowel preparation.
  3. Patient is instructed on pre-operative diet and medication guidelines.
  4. Patient undergoes the proctectomy procedure, which may be done through open surgery, laparoscopic surgery, or robotic surgery.
  5. Patient is monitored closely in the immediate post-operative period for any complications.

After proctectomy:

  1. Patient is monitored in the hospital for a few days to ensure proper healing and recovery.
  2. Patient may be given pain medication and antibiotics to prevent infection.
  3. Patient is encouraged to start moving and walking as soon as possible to prevent blood clots and promote healing.
  4. Patient may be discharged from the hospital and instructed on post-operative care, including wound care, diet restrictions, and activity limitations.
  5. Patient follows up with the surgeon for post-operative appointments to monitor healing and address any concerns or complications.

What to Ask Your Doctor

  1. How will my obesity affect the complexity and success of the proctectomy surgery?
  2. Are there any specific risks or complications associated with performing a proctectomy on an obese patient?
  3. What steps will be taken to ensure the best possible outcome for the surgery, given my obesity?
  4. Will the use of robotic surgery make the procedure more challenging for my specific case?
  5. How experienced are you in performing proctectomy surgeries on obese patients using robotic technology?
  6. Are there any alternative treatment options or modifications to the surgery that should be considered for an obese patient?
  7. What is the expected recovery time and potential impact of my obesity on the healing process?
  8. Are there any specific post-operative care instructions or recommendations for managing the effects of obesity on the surgical outcome?
  9. How will my weight and overall health be monitored and managed throughout the surgical process and recovery period?
  10. What long-term considerations should be taken into account regarding obesity and its impact on the success of the proctectomy surgery?

Reference

Authors: Gillani M, Rupji M, Paul Olson TJ, Sullivan P, Shaffer VO, Balch GC, Shields MC, Liu Y, Rosen SA. Journal: Surgery. 2024 Dec;176(6):1591-1597. doi: 10.1016/j.surg.2024.08.015. Epub 2024 Sep 20. PMID: 39304451