The application of robotic surgery to cancer surgery: Producing better precision and prognosis
Surgical approaches include conventional open surgery and minimally invasive surgery, such as laparoscopic and robot-assisted surgery. Open surgery involves a large incision while minimally invasive surgery makes small cuts to insert a video camera and other surgical instruments. Traditional laparoscopic procedures locate a 40 cm-long instrument with small forceps hooked within the abdomen. Therefore, manipulating the tip of the surgical tool is less accurate than operating with the hands. This shortcoming can be overcome with robotic surgery. Seamlessly translating the surgeon’s wrist and finger movements into the movements of surgical instruments, robotic technology is like having miniaturized hands inside a patient’s body to make more nuanced surgical maneuvers. The 3D visibility of the robotic system gives the surgeon a view of the operative field magnified up to 10 times. This provides greater precision and accuracy, in particular for handling soft tissues such as lymphatic glands.
▲Prof. Seok-ho Kang, Director of the Robotic Surgery Center
More precise controls mean the application of the technology into a broad range of procedures.
Indeed, robot-assisted surgery can benefit almost all surgical disciplines, and the technology is actively used in surgical procedures for colorectal cancer, stomach cancer, and prostate cancer and for thyroid or hepatopancreaticobiliary surgery. Moreover, its application has recently expanded into gynecologic procedures. Robotic surgery is common for prostatectomy because robot-assisted procedures are more efficient than other approaches in operating within a narrow area without damaging surrounding tissues. Anam Hospital uses robotic surgery for cancer. During robotic procedures, the surgeon can check the blood vessels, the blood flow, and the tissue in real-time. Distinguishing cancer tissue from normal tissue is easier in robot arm-assisted surgery than other surgical procedures. In addition, several thin robotic arms can be inserted through a single incision, and using a belly-button incision leaves no visible scar. Robotic surgery produces higher precision and a faster recovery, thus improving patient outcomes.
Leading in training of robotic surgery and standard-setting: The roles and responsibilities of university hospitals
KUAH’s milestone of 3,000 cases of robotic surgery was only possible thanks to the efforts and dedication of its professors, who have taken initiative in developing and applying the latest surgical procedures based on cutting-edge equipment.The robot-assisted surgical procedure developed by Prof. Seon-Hahn Kim of the Department of Colorectal Surgery is recognized as the world’s standard for colorectal cancer robotic surgery.
And Prof. Jun Cheon of the Department of Genito-Urology wrote a part of Robotic Urologic Surgery, a textbook for robotic urologic surgery published by Springer.
Prof. Seok-Ho Kang of the Department of Genito-Urology has performed the highest number of robotic radical cystectomy procedures with total intracorporeal urinary diversion after having introduced the surgery for the first time in Asia. Prof. Eul-Sik Yoon of the Department of Plastic and Reconstructive Surgery is the first in Korea to perform a robotic scarless reconstructive surgery. Prof. Hoon-yub Kim of the Department of Thyroid Center has drawn attention from the world medical communities for his development of the world’s first transoral robotic thyroidectomy. Prof. Kwang-Yoon Jung and prof. Seung-Kuk Baek of the Department of Otorhinolaryngology perform thyroid surgery while hiding the surgical scar in the hairline. Profs. Jae-Yoon Song and Sang-Hoon Lee of the Department of Obstetrics and Gynecology lead robot-assisted surgery for gynecologic cancer. All those professors are the pillars of the Robotic Surgery Center.
As described above, KUAH has achieved equal growth and development in terms of robot-assisted surgery, instead of concentrating on a specific medical department. It has expanded the application of robotic surgery to treatment of various diseases or cancers, including prostate, colon, rectal, thyroid, bladder, kidney, and obstetrics and gynecologic cancer or disease, and breast reconstruction. The Robotic Surgery Center has a high percentage of surgical operations of severe diseases whose procedures are more time-consuming than those of other diseases. This attests to the fact that KUAH has prioritized offering the best medical services to patients over generating profits.
The Center has also focused on leading the development of future medical technology and the cultivation of talent, the core roles expected from higher education. As a part of such endeavors, it has introduced the Robotic Surgery Certification which regulates that any robotic procedures should pass the review of the Robot Surgery Certification Committee. In addition, the Center operates the Robot Simulation Center to enhance skills and techniques of medical professionals at home and abroad and develop diverse simulation programs of surgical procedures, thus offering effective training programs.
“KU’s Robotic Surgery Center boasts a proud history of leading the development of robotic surgery in Korea,” said Prof. Seok-Ho Kang, Director of the Robotic Surgery Center, adding, “We’re committed to developing and systemizing new robotic surgical procedures as the leader of the field.”
Medical Firsts Achieved by KU’s Robotic Surgical Center
2007: Developed the world’s first single-stage fully robotic low anterior rectal cancer resection (Prof. Seon-Hahn Kim)
2007: Succeeded in Asia’s first robot-assisted orthotopic bladder substitution (Prof. Seok-Ho Kang)
2008: Succeeded in Asia’s first en bloc pelvic lymphadenectomy (Prof. Seok-Ho Kang)
2010: Wrote a part of Robotic Urologic Surgery published by Springer, the first in Asia (Prof. Jun Cheon)
2011: Succeeded in Asia’s first total intracorporeal urinary diversion (Prof. Seok-Ho Kang)
2012: Succeeded in Korea’s first robotic breast reconstruction (Prof. Eul-Sik Yoon)
2012: Succeeded in the world’s first transoral robotic thyroidectomy (Prof. Hoon-Yub Kim)
2014: Performed and reported the world’s first robotic combined pelvic organ resection (Prof. Seon-Hahn Kim, Colorectal disease: The Journal of the Association of Coloproctology of Great Britain and Ireland)
2016: Performed Asia’s first 100 cases of robotic radical cystectomy (Prof. Seok-ho Kang)
2017: Reported that robotic surgery was better than laparoscopic surgery for rectal cancer in terms of higher chance of long-term living (Prof. Seon-Han Kim, The Diseases of the Colon and Rectum: The Journal of the American Society of Colon and Rectal Surgeons)
2018: performed 100 cases of total intracorporeal urinary diversion, the first in Asia (Prof. Seok-Ho Kang)