Robotic or Laparoscopic Surgery! Which is Better for Cancer?


For a long time, cancer has been treated with conventional open surgery that left patients with pain and prolonged recovery. However, technical and technological development over the past few decades has changed a lot of things. Thus, nowadays surgery need not be as painful and gruesome as it was a decade or more ago. Today we can safely say open surgery, though effective, is outdated. Minimally invasive Cancer Surgery in the form of robotic or laparoscopic surgery is the stand of care.

What is the difference between laparoscopic and robotic surgery?

Let us first understand what is laparoscopic surgery. Laparoscopic surgery uses small wounds to perform a surgical operation on a patient. The surgeon operates looking at the image on a medical grade high definition monitor. The technique is safe and effective.

Robotic surgery is an advancement over laparoscopic surgery wherein the surgeon gets few more advancements over laparoscopy. The surgeon’s vision is a 3D vision and the instruments are flexible and have better movement. In both laparoscopy and robotic the surgery is performed by the surgeon. The role of the robot is only to improve the precision.

When do I choose robotic surgery for my patients?

The debate about which is the best cancer treatment available, open or laparoscopic or robotic, has existed for some time now. And like any other scientific question, this has to be proved by research alone. The research available today has proven undoubtedly that what matters is the surgical technique rather than the technology that is used. This means that the long-term outcome of cancer is same weather surgeries performed by open, laparoscopic or robotic. What differs between the three is the patient comfort and long-term complications, and surgeons comfort in delivering a high-quality surgery.

Robotic technology is the most advanced cancer treatment available today. It makes it easier to operate in very narrow spaces within the body. These narrow spaces include:

  • Very low part of the rectum (back passage, ಗುದನಾಳ) in order to save the anus (ಗುದದ್ವಾರ ಉಳಿಸಲು)
  • Some esophagus (ಅನ್ನನಾಳ) cancers where extensive lymph node removal is needed.
  • Prostate cancers to perform accurate radical surgery
  • Some kidney cancers to save the kidney by removing only the tumor.
  • Throat cancers where no other equipment can reach.

In my experience, most of the other cancer surgeries can be performed laparoscopically as precisely as robotically. I do agree that the skills required for laparoscopy are much more and many surgeons may offer robotic surgery for simpler surgeries based on their skill levels.

Key Message:

The long-term result of cancer treatment depends on the quality of surgery and not on the approach (open vs laparoscopic vs robotic). A patient can choose robotic or laparoscopic surgery for many other benefits that they provide.

By Dr Sandeep Nayak

Author is a leading surgical oncologist of Bangalore presently heading MACS Clinic as well as Fortis Hospital, Bangalore. He is a well acclaimed specialist in robotic and laparoscopic cancer surgeries. He has been a teaching faculty at Kidwai Cancer Institute, Bangalore, which is one of the leading teaching institutes in Oncology in India. He has keen interest in public education and awareness. He shares his thoughts and facts on this blog.