Our Summary

This study looked at the availability of robotic surgery for rectal cancer and found that it is not evenly distributed among all patients. It found that patients who are more likely to receive this kind of surgery are male, white, privately insured, and living in a metropolitan area. They are also more likely to have stage III cancer, live more than 25 miles away from the hospital, and live in an area with a high high school graduation rate. The hospitals that are more likely to offer this type of surgery are academic and high volume. This means that people who are female, black, older, publicly insured, or cannot travel to a large teaching hospital are less likely to have access to this type of surgery. The researchers warn that this disparity could skew the results of studies about robotic surgery, as they may not be representative of all patients.

FAQs

  1. What demographic is most likely to receive robotic surgery for rectal cancer according to this study?
  2. What type of hospitals are more likely to offer robotic surgery for rectal cancer?
  3. How could the uneven distribution of robotic surgery availability affect the results of studies on this type of surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about proctectomy is to discuss with your healthcare team the different surgical options available, including robotic surgery. It is important to understand the potential benefits and risks of each option and to ensure that the chosen procedure is the best fit for your individual circumstances. Additionally, it may be beneficial to inquire about the availability of robotic surgery at the hospital where you will be receiving treatment, as access to this technology can vary depending on factors such as insurance coverage and geographic location. By being informed and proactive, you can work with your healthcare team to make the best decision for your care.

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) with severe complications
  • Familial adenomatous polyposis (FAP) with significant polyp burden
  • Rectal prolapse
  • Severe hemorrhoids that do not respond to other treatments
  • Rectal trauma or injury
  • Chronic constipation or defecation disorders that do not respond to other treatments

The decision to recommend proctectomy is typically made by a colorectal surgeon after a thorough evaluation of the patient’s condition and medical history. Factors such as the extent of the disease, response to previous treatments, overall health status, and patient preferences are taken into consideration when determining the most appropriate course of treatment.

Timeline

Before proctectomy:

  1. Patient is diagnosed with rectal cancer and undergoes various tests and consultations with healthcare providers.
  2. Patient may undergo neoadjuvant therapy (chemotherapy and/or radiation) to shrink the tumor before surgery.
  3. Patient meets with a colorectal surgeon to discuss the surgical options, including proctectomy.
  4. Patient undergoes pre-operative preparations, such as bowel preparation and dietary restrictions.

After proctectomy:

  1. Patient undergoes the surgical procedure, either through traditional open surgery, laparoscopic surgery, or robotic surgery.
  2. Patient stays in the hospital for a few days to recover and monitor for any complications.
  3. Patient may require a temporary colostomy or ileostomy, which will be reversed in a later surgery.
  4. Patient undergoes post-operative care, including pain management, physical therapy, and monitoring for any signs of infection or other complications.
  5. Patient follows up with their healthcare team for regular check-ups and surveillance to monitor for any recurrence of cancer.

What to Ask Your Doctor

  1. What is the reason for recommending a proctectomy?
  2. What are the potential risks and complications associated with the surgery?
  3. What type of proctectomy procedure will be performed (e.g. open, laparoscopic, robotic)?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. How will the surgery affect bowel function and quality of life?
  6. Are there any alternative treatment options available besides proctectomy?
  7. How experienced is the surgical team in performing proctectomy procedures?
  8. What is the success rate of proctectomy in treating the condition?
  9. Will there be a need for additional treatments or follow-up care after the surgery?
  10. What lifestyle changes or modifications may be necessary post-proctectomy?

Reference

Authors: Ofshteyn A, Bingmer K, Towe CW, Steinhagen E, Stein SL. Journal: Surg Endosc. 2020 Jun;34(6):2651-2656. doi: 10.1007/s00464-019-07041-0. Epub 2019 Aug 1. PMID: 31372887