How Do You Decide Whether to Do Robotic or Open Surgery to Treat Cancer?

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An open surgery is done if specifically for cancer if the tumor extra patient is not going to be able to be brought out through a small key hole incision. Some of the cancers that we operate on the tumors are quite large, we need to be able to make an incision to actually remove the tumor, but for early stage cancers in which tumors are not large, and we're just doing staging those individuals may be great candidates for laporoscopy or Robotic surgery. Generally Robotic surgery is reserved in my practice for more complicated situations and straight laparoscopy used for less complicated indications. Robotic surgery again is an interesting topic in terms of our healthcare Dollars because that's very expensive equipment and if a surgery can be done effectively with lesser expensive equipment it probably should be done with the more cost effective rate equipment but for many individuals robotic surgery is actually allows us to take an operation that would still traditionally be done with an open procedure even with regular laparoscopy and take that more complicated open procedure and turn it into a laparoscopic procedure. Complication rate is lower actually I would say with laparoscopic surgery or robotic surgery wound infection rate is much lower with a laparoscopic procedure for some very large individuals or obese individuals a wound infection rate may approach as high as 30% because of their obesity actually and with a laparoscopic procedure the wound infection rate is actually much lower, so in some situations the complication rate may actually be much lower. In terms of success rate, in terms of adequacy of the operation I think that needs to be always assumed that when you're going in to do a cancer operation via laparoscope or a robotic approach it must be the same as the open approach where it shouldn't be done, you should never compromise a cure to do something through a minimally invasive procedure.