Robotic surgery transforms rectal cancer care by enabling tumour removal without abdominal cuts

For decades, rectal cancer surgery has often involved complex procedures requiring abdominal incisions and in some cases, a temporary or permanent stoma that changes how patients manage daily life after treatment. However, advances in robotic and minimally invasive techniques are now allowing selected patients to undergo tumour removal while preserving normal body function.

In a significant development in colorectal cancer care, doctors at Fortis Hospital Manesar successfully performed Robotic Transanal Minimally Invasive Surgery (TAMIS) on a 45-year-old Australian patient, enabling complete removal of a recurrent rectal tumour without abdominal cuts or the need for a temporary stoma. The patient, who had been battling rectal cancer for 18 months and had previously undergone chemotherapy and radiation therapy in Australia, recovered quickly and was discharged within two days.

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Robotic technology improves precision and organ preservation

Explaining the significance of the procedure, Dr. Vinay Samuel Gaikwad, Senior Director, Surgical Oncology, Fortis Hospital Manesar, said, “The patient had recurrent early-stage rectal cancer and was facing a surgery that would typically require abdominal incisions and a temporary stoma. After careful evaluation, we identified him as an ideal candidate for Robotic TAMIS, which enabled us to remove the tumour with exceptional precision through a minimally invasive approach, avoiding abdominal cuts and the need for an external bag. He recovered well and was discharged within two days. This case demonstrates how advanced robotic techniques can help preserve quality of life while delivering excellent clinical outcomes for carefully selected patients.”

Dr. Gaikwad added that robotic surgery has transformed complex cancer procedures by improving surgical accuracy, protecting surrounding nerves and increasing organ and sphincter preservation rates.

“Robotic surgery works on a master-slave relationship, where the surgeon controls robotic instruments that provide enhanced movement and precision in narrow anatomical spaces. This allows surgeons to remove tumours more accurately while preserving important structures wherever possible,” he said.

Recognising symptoms can improve early diagnosis

Rectal cancer symptoms can often be overlooked as common digestive problems, delaying diagnosis. According to Dr. Gaikwad, warning signs that should not be ignored include blood in stool, changes in bowel habits, unexplained weight loss and loss of appetite.

“These symptoms are sometimes mistaken for piles or haemorrhoids, leading people to delay medical consultation. Any persistent change in bowel habits or presence of blood in stool should be evaluated by a doctor,” he said.

Lifestyle and genetic factors influence risk

Several lifestyle and hereditary factors can increase the risk of rectal cancer. Dr. Gaikwad highlighted that diets high in processed foods, red meat and smoked foods, along with low fibre intake and prolonged constipation, may contribute to increased risk.

Maintaining a healthy lifestyle, including regular physical activity and a diet rich in fruits and vegetables, can help lower risk. He added that around 15% of cases may have a family-related or genetic association, making awareness of family history important.

Advanced diagnosis helps guide treatment decisions

Rectal cancer diagnosis usually involves colonoscopy, either as part of screening or after symptoms appear. Once cancer is detected, biopsy and imaging tests such as PET scans help determine the stage of disease and guide treatment planning.

“Early and accurate diagnosis is critical because treatment decisions depend on the stage and biological characteristics of the cancer. Advanced testing helps doctors design a more effective and personalised treatment strategy,” Dr. Gaikwad said.

Modern treatment focuses on survival and quality of life

Rectal cancer treatment generally involves a multidisciplinary approach combining radiation therapy, chemotherapy and surgery. While early-stage cancers may sometimes be treated with surgery alone, advanced cases often require a combination of therapies.

Dr. Gaikwad said robotic procedures such as TAMIS have improved outcomes for selected patients by helping preserve sphincter function and avoid permanent changes to bowel function.

“Robotic surgery and advanced minimally invasive procedures have helped improve quality of life by increasing the possibility of sphincter preservation and allowing patients to maintain normal bowel passage after surgery. Targeted therapies and immunotherapy have also expanded treatment options and improved survival outcomes in appropriate cases,” he said.

Early detection remains key to better outcomes

Doctors emphasise that early detection significantly improves the chances of successful treatment. Detecting rectal cancer at an earlier stage can reduce treatment intensity and may help some patients avoid extensive chemotherapy or radiation.

“Early diagnosis increases the possibility of cure and allows treatment to be less demanding. Emerging tools such as circulating tumour cell detection may also help doctors determine treatment intensity and monitor disease more effectively,” Dr. Gaikwad said.

India’s growing role in advanced cancer care

Highlighting the hospital’s focus on technology-driven healthcare, Mr. Indrajeet Kumar Singh, Facility Director, Fortis Hospital Manesar, said, “This successful treatment reflects Fortis Hospital Manesar’s commitment to bringing world-class, technology-driven healthcare solutions to patients from across India and around the globe. As healthcare technology continues to evolve, our focus remains on adopting cutting-edge technologies and evidence-based practices that enhance patient outcomes and redefine standards of care in complex cancer treatment.”

For the patient (Samy), the procedure marked the end of a difficult journey. “When I was told in Australia that I would need major surgery and a temporary external bag, it was incredibly daunting. To undergo this advanced robotic surgery, have the tumour completely removed without a single cut on my abdomen, and be discharged in just two days feels like a miracle. I am returning home to Australia cancer-free, without a bag, and with my normal life intact,” he said.