GASTROINTESTINAL (GI) MALIGNANCIES AND ROBOTIC PROCEDURES
Gastrointestinal (GI) malignancies are cancers that arise from the digestive tract and its associated organs. They include cancers of the oesophagus, stomach, small intestine, colon, rectum, anus, liver, gall bladder, bile ducts, and pancreas. These cancers vary in their biological behaviour and stage at presentation but often require a multidisciplinary approach involving surgery, medical oncology, radiation oncology, gastroenterology, pathology, and radiology.
Robotic gastrectomy and colectomy are performed under general anaesthesia with the patient positioned to provide optimal access to the abdomen. Several small incisions are made for the placement of robotic ports, through which a high-definition three-dimensional camera and robotic instruments are introduced. After docking the robotic system, the abdominal cavity is systematically explored to assess the extent of disease and confirm resectability. The stomach or colon is carefully mobilised by dividing the supporting attachments while preserving critical surrounding structures. Major blood vessels supplying the affected segment are identified, ligated, and divided, followed by meticulous dissection along the appropriate anatomical planes. The tumour-bearing portion of the stomach or colon is then resected with adequate oncological margins, and regional lymph node dissection is performed when indicated for malignant disease. Gastrointestinal continuity is restored by creating a robotic or stapled anastomosis between the remaining segments of the digestive tract. Following confirmation of haemostasis and assessment of the anastomosis for integrity, the resected specimen is retrieved through a small protected incision. Surgical drains may be placed when required, the robotic instruments are withdrawn, and the port sites are closed, completing the procedure.