WashU Medicine surgeons at Siteman Cancer Center are world-class leaders with a legacy of surgical innovations, including the use of robotics and minimally invasive surgical techniques. They also train future surgical leaders by facilitating the top residencies and specialized fellowships in the country.
Our Siteman care coordinators – oncology-trained nurses who help with scheduling, finding the right specialist, and guidance – can help you through the process.
Call us directly or submit a form, and we will call you back.
About Minimally Invasive and Robotic-Assisted Surgery
The two main types of minimally invasive surgeries are:
- Laparoscopic surgery: a surgical team guides a light and camera while the surgeon sits at the bedside in the operating room, using surgical tools to perform the surgery.
- Robotic surgery: a surgeon controls the arms and hands of a robot, as well as a light and camera, from a console in the operating room. They perform the operation after making small incisions in the patient’s body.
WashU Medicine surgeons at Siteman Cancer Center started performing robotic-assisted surgery in the 1990s, and Siteman was one of the first institutions to perform a laparoscopic kidney removal to treat a patient with renal cancer. This pioneering spirit has driven a number of developments at Siteman, with scientists and researchers from WashU Medicine leading novel approaches to improve patient outcomes.
Patients benefit from minimally invasive and robotic-assisted surgery in the following ways:
- Smaller incisions rather than a single large one
- Less pain than open procedures
- Less risk of infection
- Less blood loss
- Reduces damage to other nearby organs and tissues
- Shorter hospital stays
- Quicker recovery
Surgeons have greater clarity and precision during these types of operations. The 3D imaging tools in the cameras allow them to zoom in and see where the cancer is with greater accuracy than the human eye. That technology helps guide the procedure and lowers the risk of complications.
Why Choose Siteman
At Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine, surgeons are trained in advanced methods of minimally invasive surgery to propel this type of medicine forward. With a focus on improving patient comfort and outcomes, they develop next-generation techniques that target cancer more effectively and reduce surgical risks.
Other leading institutions recognize Siteman’s innovative work to develop cutting edge therapies and approaches that work against cancer. The National Cancer Institute (NCI) recognizes Siteman Cancer Center with the highest ranking of “exceptional,” making it the only NCI-designated Comprehensive Cancer Center in the region. Siteman is also one of the largest cancer centers in the United States based on patients treated, with more than 75,000 patients a year.
WashU Medicine surgeons at Siteman are at the forefront of innovation and boast a legacy of surgical excellence. They were the first in the region to perform a laparoscopic colectomy for a patient with colon cancer in the 1990s and have continued to develop the technique since then. They dedicate themselves to treating even the most complex health problems to provide personalized care for your specific type of cancer.
By situating our treatment center in an advanced academic research institution, our patients can trust surgeons who have mastered one of medicine’s most technically demanding specialties.
Clinical trials are research studies that help us find new ways to prevent, diagnose, and treat cancer. If you have a rare or complex diagnosis or your treatment path seems uncertain, you might qualify for a clinical trial.
Our team will help you find a study that is right for you. Call us to speak with a Siteman care coordinator.
Understanding Minimally Invasive and Robotic-Assisted Surgery
During these procedures, WashU Medicine surgeons lead the procedures and are active in creating and executing the surgical plan. The surgical team stands in the operating room to monitor the patient the whole time. The lead surgeon sits in a chair and operates from a console just a few feet away in the same room.
The robot has four mechanical arms that mimic the movements of the human body, but with the added benefit of having 3D imaging that the surgeon can use to guide the device. The arms are equipped with whatever surgical tools the surgeon needs to perform the operation.
Different types of cancer might require different types of robotic techniques.
- Patients with brain tumors might undergo one of the following types of surgical procedures:
- Keyhole surgery: surgeons drill a small hole and perform this procedure with the assistance of tiny cameras and other tools that allow them to see and work inside the brain.
- Transphenoidal surgery: surgeons use tiny cameras called endoscopes, which they insert through the nose, to visualize the tumor and operate safely during this operation. It requires no external incisions and allows surgeons to extract pituitary tumors or tumors of the anterior skull base.
- MRI-guided laser interstitial thermal therapy (LITT): surgeons use a robotic arm and MRI imaging to steer the laser probe through the brain and into the tumor. When doctors place the probe inside the tumor, it uses intense heat to kill tumor cells. Surgeons use this to treat patients with gliomas, metastatic tumors, and meningiomas.
- Transorbital neuroendoscopic surgery (TONES): surgeons remove a patient’s tumor using neuroendoscopic tools without needing to remove a portion of the patient’s skull. This type of surgery is used for patients who have tumors in the base of their brain, the frontal lobe, or the temporal lobe.
- For patients with colorectal cancer, surgeons perform partial colectomies at Siteman using minimally invasive or laparoscopic techniques. They might also perform a transanal endoscopic microsurgical (TEM) excision, which removes benign polyps and early cancers from the rectum.
- For esophageal cancer, surgeons use robotic-assisted tools to perform an esophagectomy, which removes some or all the esophagus.
- For certain gynecological cancers, especially uterine (or endometrial) cancer, patients benefit from robotic-assisted hysterectomies that tend to have a faster recovery time than patients who undergo traditional surgery.
- Head and neck cancers vary so they might require different types of surgery.
- Transoral laser microsurgery is a minimally invasive technique used to treat early-stage oropharyngeal and laryngeal tumors. Surgeons extend a tiny laser through the mouth and into the throat and use it to cut tumors away from surrounding tissues. Because the structures of the larynx (voice box) and oropharynx are crucial for speaking and swallowing, this technique can play a vital role in preserving the patient’s quality of life.
- Transoral Endoscopic Thyroidectomy (TOETVA), also called a scarless thyroidectomy, uses three small incisions on the lower gumline avoiding an external scar and enhancing visualization of critical structures. During TOETVA, surgeons use endoscopic instruments to remove the thyroid. Siteman was the first in Missouri to perform this procedure.
- Transoral robotic surgery (or TORS) allows doctors to extract throat tumors through the mouth instead of making a large incision. During a TORS procedure, surgeons use a control panel to manipulate one or more robotic arms, which conduct the surgery inside the throat with the aid of a small camera.
- For patients with kidney cancer, surgeons use minimally invasive surgeries to remove the kidney or robotic-assisted surgeries for partial kidney removal. WashU Medicine surgeons at Siteman developed this highly technical discipline, and only a few cancer centers in the country perform this complex procedure.
- For lung cancer, surgeons use robots to assist during a lobectomy, which involves removing the cancerous lobe of the lung. Surgeons at Siteman perform an average of 150 lobectomies a year. They may also use video-assisted thoracoscopic surgery, or VATS, which uses a small video camera inserted through the patient’s chest.
- Patients with prostate cancer might receive a male lumpectomy from surgeons who use minimally invasive or robotic-assisted techniques. This approach kills the tumor by using MRI-guided lasers or needles and carries no risk of incontinence or sexual dysfunction.
Learn more about the Whipple procedure for pancreatic cancer
Your Second Opinion at Siteman
Siteman wants to be your first choice for cancer care, but that might not always be possible. If you have received a cancer diagnosis, started care somewhere else, or are a physician seeking specialized care for your patient, ask us about a second opinion. You can start the process. To make it easy, our care coordinators guide scheduling for yourself or your patient.
Frequently Asked Questions About Minimally Invasive or Robotic-Assisted Surgery
Your care team will provide you with detailed information about what to expect for surgery, which depends on your specific case and cancer type.
In general, doctors will place you under anesthesia before the surgery begins, so you will not be awake for the procedure. The surgeons will make a few small incisions to insert the robotic device or laparoscope, which will then be stitched after the operation is complete.
Surgeons perform most minimally invasive and robotic-assisted surgeries on an outpatient basis, meaning you will be able to leave the hospital after your operation to recover in the comfort of your home. Some surgeries may require a brief hospital stay after the operation to allow nurses and doctors to monitor your recovery closely.
Since the incisions are smaller than traditional open surgeries, most patients recover quickly and can resume normal activities in a shorter time frame. Your risk of infection, scarring, and pain are greatly reduced when surgeons can perform minimally invasive or robotic-assisted surgery.
Your care team will provide you with specific post-operation instructions about the care, recovery procedures, medication, and follow-up appointments.
Any surgery poses some risks, but robotic surgeries tend to have fewer than traditional open surgeries. Some complications might include:
- Blood loss
- Infection
- Trouble breathing
Your physician will also review any risks you might encounter depending on your cancer type and medical history. Be sure to ask your care team about any specific concerns you might have before the operation.
Whether you are a good candidate for minimally invasive or robotic-assisted surgery varies by your cancer type, stage of the cancer, and your medical history. In general, if the tumor is outside of an organ and not attached to blood vessels, your care team may determine that this is the best procedure for you.
Your care team will thoroughly review your case before they decide on this procedure with you. If you are not a good candidate for it, we will still treat you with the best options available.
Sometimes a patient might undergo chemotherapy before minimally invasive surgery. This helps shrink the tumor to make it more likely that the surgery will be effective. Patients might also undergo chemotherapy after the procedure.
