MRI and Robotic for Rectal

Jen1988

Dear All,

I would like to hear from anyone who had Robotic surgery for rectal cancer. My husband (stage 3 with lymph node involvement) will finish his 6 weeks chemoradiation next week. 

We spoke to 3 surgeons. The 1st doctor wants to do open surgery with incission starting from belly down. The 2nd and 3td doctor want to have Robotic as they think would be more beneficial. The 3rd doctor also ordered mri before operation to help him with the surgery later.

We haven't decided which doctor ... it's very difficult to choose... we feel all 3 are really good. 2nd and 3rd are chief colorectal surgeon at  different hospital

Is it a standard protocol to get mri before operation for lymph node involvement? 

Hubby only had PET and CT prior chemoradiation

Lovekitties

Hi Jenny

I have not heard of Robotic being used for removal of a rectal tumor, but that doesn't mean it hasn't been done.  Mine was the full incission.

I guess a lot depends on what they beleive to be the position and size of the tumor and how confident they are that there is no other involvement.

Not sure about the MRI either.  Normal process is CT and or PET with contrast to determine any cancer sites.  The contrast component being what causes the cancer sites to illuminate.  No test can guarantee finding all spots.

The pros for Robotic are that it is less invasive and has a quicker recovery time.  The con is that the surgeon has a limited field of view to spot any other questionable spots which might not have shown up on the scans.

Since you have already had multiple surgeons look at his case, you just have to make a choice you can feel comfortable with now and in the future, no matter what that future is.  No second guessing, if only we had chosen differently.

Wishing hubby best outcome no matter which option chosen.

Marie who loves kitties

Jen1988

Lovekitties said:

Hi Jenny

I have not heard of Robotic being used for removal of a rectal tumor, but that doesn't mean it hasn't been done.  Mine was the full incission.

I guess a lot depends on what they beleive to be the position and size of the tumor and how confident they are that there is no other involvement.

Not sure about the MRI either.  Normal process is CT and or PET with contrast to determine any cancer sites.  The contrast component being what causes the cancer sites to illuminate.  No test can guarantee finding all spots.

The pros for Robotic are that it is less invasive and has a quicker recovery time.  The con is that the surgeon has a limited field of view to spot any other questionable spots which might not have shown up on the scans.

Since you have already had multiple surgeons look at his case, you just have to make a choice you can feel comfortable with now and in the future, no matter what that future is.  No second guessing, if only we had chosen differently.

Wishing hubby best outcome no matter which option chosen.

Marie who loves kitties

Hi Marie,
thank you for your

Hi Marie,

thank you for your respond. I read your profile and learn that you did not have chemo or radiation. May i know the stage of cancer you had? My husband is having bad side effects from chemo,. though 5fu he is getting now is only small amount compare to what he will have after surgery. The onc already reduced this light chemo to 80 % than recommended due to side effects,.. And he is still suffering. We are very concern what will happen on the 2nd chemo with much higher dose plus 2 other chemo drugs.

Thanks so much for your warm support

Jenny

lp1964

Dear Jenny,

I had my rectal cancer removed(APR) 2.5 years ago. They removed the rectum and the anus and now I have colostomy. They also took one of my abdominal muscle, folded it down and filled the space where the rectum used to be. This way my intestines will not sink into the pelvic area. 

The pelvic space is very tight and hard to operate by hand. However if they cannot save his anus, the visibility is good from the bottom and they can do the robotic surgery. 

I highly recommend the abdominal muscle flap if they cannot save his anus. They can close the bottom up better. Otherwise he is not gonna have a "crack", the radiated skin may not heal as well and he might have complication with the intestinal prolapse. 

If they can save the anus robitic surgery is better in my opinion. 

Dont let them operate on him for 10-12 weeks after radiation. Radiation still is killing the cancer for 2 more months. Also start taking at least 2x400mg/day Cimetidine (over the counter) 2 weeks before and 2 weeks after the surgery to lower the risk of the cancer spreading. 

Good lick,

Laz

Jen1988

lp1964 said:

Dear Jenny,

I had my rectal cancer removed(APR) 2.5 years ago. They removed the rectum and the anus and now I have colostomy. They also took one of my abdominal muscle, folded it down and filled the space where the rectum used to be. This way my intestines will not sink into the pelvic area. 

The pelvic space is very tight and hard to operate by hand. However if they cannot save his anus, the visibility is good from the bottom and they can do the robotic surgery. 

I highly recommend the abdominal muscle flap if they cannot save his anus. They can close the bottom up better. Otherwise he is not gonna have a "crack", the radiated skin may not heal as well and he might have complication with the intestinal prolapse. 

If they can save the anus robitic surgery is better in my opinion. 

Dont let them operate on him for 10-12 weeks after radiation. Radiation still is killing the cancer for 2 more months. Also start taking at least 2x400mg/day Cimetidine (over the counter) 2 weeks before and 2 weeks after the surgery to lower the risk of the cancer spreading. 

Good lick,

Laz

Cimetidine

Dear Laz,

Thank you for your advise. All 3 said that they can save the anus,.. he will need to get ileostomy. They want to do operation between 6-8 weeks but i will ask if they can do at 10 weeks as you have suggested in previous posting. 

I am also interesested in giving Cimetidine for hubby. Do i need to get permission from the onc or the surgeon? I see that it's over the counter... just curious if your doctor gave you suggestion or you do it on your own? Also ... 2 weeks before surgery,.. did you take it until the surgery date? and 2 weeks after surgery for how long?

Thank you again for your kind support

Jenny

John23

Jen1988 said:

Cimetidine

Dear Laz,

Thank you for your advise. All 3 said that they can save the anus,.. he will need to get ileostomy. They want to do operation between 6-8 weeks but i will ask if they can do at 10 weeks as you have suggested in previous posting. 

I am also interesested in giving Cimetidine for hubby. Do i need to get permission from the onc or the surgeon? I see that it's over the counter... just curious if your doctor gave you suggestion or you do it on your own? Also ... 2 weeks before surgery,.. did you take it until the surgery date? and 2 weeks after surgery for how long?

Thank you again for your kind support

Jenny

An analogy..(?)

An analogy..(?)

 

When my wife suffered a ruptured cerebral aneurysm, her (very experienced) brain surgeon said he didn’t do robotic surgery. The method of “robotically” inserting a tiny “coil spring” device inside the vein to stop the bleeding was suggested by another surgeon, but rejected by her surgeon. He said that if anything went wrong during the procedure, it would have to be reversed, with time lost and possible life-threatening complications.

And, he continued, with open surgery if there is anything else that should be taken care of, he would be able to see it while performing the open surgery.

He was 100% right. He went in between the two frontal lobes where the rupture was, and found that there was a second ruptured aneurysm directly below the vein he was to repair. He repaired both ruptures at that time.

That….. is the benefit of an “open surgery” versus using the “latest and greatest”.

(and of course, the added benefit of saving money with the “BoGo” special)

(ha)

I would go with the surgeon with the most experience and the most knowledge; new technology isn’t always the best technology.

Oh, by the way…. Make sure that the surgeon leaves the “sphincter muscle” intact, anus or no anus. That has been said to make life 1,000,000 times better after that kind of removal…. You can get more info regarding that procedure at the United Ostomy Association of America (UOAA) website!

Be well. You both have my very best wishes.

John

lp1964

Jen1988 said:

Cimetidine

Dear Laz,

Thank you for your advise. All 3 said that they can save the anus,.. he will need to get ileostomy. They want to do operation between 6-8 weeks but i will ask if they can do at 10 weeks as you have suggested in previous posting. 

I am also interesested in giving Cimetidine for hubby. Do i need to get permission from the onc or the surgeon? I see that it's over the counter... just curious if your doctor gave you suggestion or you do it on your own? Also ... 2 weeks before surgery,.. did you take it until the surgery date? and 2 weeks after surgery for how long?

Thank you again for your kind support

Jenny

Definitely...

...tell the surgeon that you have been taking it. It is an anticid medication. I took it to the day of the surgery and took it 2 weeks beyond.

all the best.

laz

Jen1988

John23 said:

An analogy..(?)

An analogy..(?)

 

When my wife suffered a ruptured cerebral aneurysm, her (very experienced) brain surgeon said he didn’t do robotic surgery. The method of “robotically” inserting a tiny “coil spring” device inside the vein to stop the bleeding was suggested by another surgeon, but rejected by her surgeon. He said that if anything went wrong during the procedure, it would have to be reversed, with time lost and possible life-threatening complications.

And, he continued, with open surgery if there is anything else that should be taken care of, he would be able to see it while performing the open surgery.

He was 100% right. He went in between the two frontal lobes where the rupture was, and found that there was a second ruptured aneurysm directly below the vein he was to repair. He repaired both ruptures at that time.

That….. is the benefit of an “open surgery” versus using the “latest and greatest”.

(and of course, the added benefit of saving money with the “BoGo” special)

(ha)

I would go with the surgeon with the most experience and the most knowledge; new technology isn’t always the best technology.

Oh, by the way…. Make sure that the surgeon leaves the “sphincter muscle” intact, anus or no anus. That has been said to make life 1,000,000 times better after that kind of removal…. You can get more info regarding that procedure at the United Ostomy Association of America (UOAA) website!

Be well. You both have my very best wishes.

John

Dear John,
Thanks for the

Dear John,

Thanks for the analogy,.. It does make sense.. about the sphincter muscle,.. we will make sure the surgeon leaves it intact. Thank you for your suport

jenny

Lovekitties

Jen1988 said:

Hi Marie,
thank you for your

Hi Marie,

thank you for your respond. I read your profile and learn that you did not have chemo or radiation. May i know the stage of cancer you had? My husband is having bad side effects from chemo,. though 5fu he is getting now is only small amount compare to what he will have after surgery. The onc already reduced this light chemo to 80 % than recommended due to side effects,.. And he is still suffering. We are very concern what will happen on the 2nd chemo with much higher dose plus 2 other chemo drugs.

Thanks so much for your warm support

Jenny

Hi Jenny

I never received nor wanted an official staging number, as it made no difference in my decision process.

My surgeon offered me chemo and radiation option to hopefully shrink the tumor to save me from a perm colostomy.

I declined because there was no guarantee that it would be "saving" treatment, only a possibility.

I also declined doing any chemo or radiation after surgery.  This was based on my age (62) at the time, life circumstance (children grown and no life partner) and also the fact that at the time I had no insurance. 

What the right choices are for one person, are not necessarily the right choices for another.

Unfortunately the effects of chemo are cummulative, so I suggest that he work with his doctor to either find additional medical options to deal with the side effects or another chemo that he may tolerate better...but there are few choices there.

Wishing you both the best outcome.

Hugs,

Marie who loves kitties