How Robotic Surgery for Colorectal Cancer Can Reduce Side Effects

Man with wife and three sons.

Robert Mendys with his wife, Beata, and their three sons. Mr. Mendys was successfully treated for rectal cancer at MSK with robotic surgery and is grateful for the chance to watch his boys grow up.

When Robert Mendys was diagnosed with stage 3 rectal cancer almost 10 years ago, he faced a profound dilemma. He wanted to make sure the cancer didn’t take him away from his wife and three young sons. But at only 46, he was very concerned about the long-term effects of surgical treatment.

“I felt that I had one shot at getting this right,” he says. “I needed to make sure I could still be here to watch my kids grow up. But I also read on patient websites that many who have had rectal surgery were having problems with urinary control and sexual dysfunction due to nerve damage.”

Still Free of Rectal Cancer and Enjoying Life

Robert sought the advice of his friends in the medical field and did more internet research. He learned that a technique called robot-assisted surgery could reduce the risk of side effects and recovery time — and that Memorial Sloan Kettering Cancer Center (MSK) had one of the most active robotic surgery programs in the nation.

Man standing with wife and 3 sons at Little Leage World Series

Robert with Beata and their sons about 10 years ago,  shortly before he was diagnosed with rectal cancer.

More than nine years after his surgery, Robert has no sign of cancer and lives an active life in southern New Jersey. He helped raise his three boys and is now enjoying retirement. 

“They were all young when I was diagnosed, and I was afraid I wouldn’t be around for them,” Robert says. “Now two are in college with the youngest headed that way – and I’m delighted to say that I’m still here.”

Benefits of Robotic Surgery

Robert is one of a growing number of patients benefiting from robot-assisted surgery, which is a type of operation called minimally invasive surgery. Unlike traditional open surgery, minimally invasive surgery uses keyhole-size incisions, often resulting in:

  • Less pain
  • Less blood loss
  • A shorter hospital stay
  • A faster recovery

How Doctors Use Robots During Cancer Surgery

In robotic surgery, a surgeon sits at a console and uses hand and foot controls to manipulate four interactive robotic arms, which are equipped with a high-definition vision system. The robot translates the surgeon’s hand, wrist, and finger movements into movements of the actual surgical instruments inside the patient.

Surgeons can see the site of operation better because the “eyes” of the device — the camera — can go very close to the tissue and project a three-dimensional image that’s then magnified tenfold. In addition, the robot takes the surgeon’s motions and scales them down, allowing for enhanced precision.

MSK Expertise in Robot-Assisted Surgery

When robotic surgery devices began to emerge around the year 2000, MSK quickly recognized the potential for expanding the number of minimally invasive procedures. At MSK more than two decades later, the majority of robotic operations are performed for gynecologic and urologic cancers, most typically hysterectomies (removal of the uterus) and radical prostatectomies (removal of the prostate).

The idea is not to use the robot as much as possible but to ask, 'What's the best approach to curing your cancer and giving you a normal life afterward?'
Mario M. Leitao, Jr. gynecologic surgeon

But robotic procedures are used for many colorectal cancers as well. At MSK, close to half of the surgeries just for colorectal cancer are done robotically. MSK leads the nation in volume of robotic colorectal surgeries, with more than 700 performed in 2023 alone.

Gynecologic surgeon Mario Leitao, MD, Director of MSK’s Minimal Access and Robotic Surgery Program, says while this technology a powerful tool, it’s the expertise of MSK’s surgeons that makes robotic surgery safe and effective.

“The idea is not to use the robot as much as possible but to ask, ‘What’s the best approach to curing your cancer and giving you a normal life afterward?’” Dr. Leitao says.

Meet the New and Improved Surgery Robot 

The robots have been continually refined over the years, with better technology added for each new generation of devices. The newest model, the da Vinci Xi, has longer arms that can rotate a full 180 degrees, enabling better access to specific sites in the patient, and includes a stapling instrument that allows the surgeon to sew the healthy parts of the colon together.

“These enhancements make it easier for the surgeon to work with more precision, which should lower complication risks even further while maintaining good outcomes regarding the treatment of the cancer,” says surgeon Julio Garcia-Aguilar, MD, Chief of the Colorectal Service in the Department of Surgery. “This means less postoperative pain, lower infection rates at the surgical site, and a lower risk of complications such as bowel obstruction and abdominal hernia.”

Faster Recovery From Colorectal Cancer Surgery 

After receiving initial treatment of chemotherapy and proton therapy at the University of Pennsylvania to drastically shrink the tumor, Robert came to MSK for a consultation with Dr. Garcia-Aguilar.

He says Dr. Garcia-Aguilar immediately put him at ease. “Dr. Garcia-Aguilar had many years of experience performing robotic surgery — and was doing several procedures a week,” Robert says. “That really made a difference for me, knowing I would be treated by someone with that kind of expertise.

Robert’s surgery was in September 2015. “What I thought was cool was they walked me into the surgical room right before the procedure and kind of introduced me to the robot,” he says. “They showed me the four arms and what they were for — gripping or cutting or the camera.”

Following the procedure — which involved removing 10 inches of his rectum —  the benefits of robot-assisted surgery were clear to him.

“When I woke up from the operation, I was happy to see just the five small incisions around my belly button,” Robert says. “Dr. Garcia-Aguilar and his whole team, including the post-surgery staff and nurses on the floor, were great. He even stopped in to see me on Sunday night after dinner.”

With no significant side effects, he was discharged and on his way home in just 72 hours.

“I credit Dr. Garcia-Aguilar’s surgical skills with the robot for the success of the operation and my recovery going so smoothly,” Robert says. “At my last follow-up appointment a few months after surgery, he hugged me and said, ‘I mean this in the best way: I hope I never have to see you again.’ I laughed and said, ‘I know just what you mean’.”

Since then, Robert has recommended MSK and Dr. Garcia Aguilar to several friends diagnosed with colorectal cancer.

“I’m so grateful,” says Robert.  “Anyone facing colorectal cancer should consider being treated at MSK. The doctors are highly skilled, and they really care about helping you live your best life.”


This story was originally published in 2016 and has been updated.