Our expert in General Surgery in Florence , Dr. Marco Scatizzi, explains to us what are the advantages of laparoscopy, and in particular of the ERAS protocol, in the treatment of patients suffering from malignancies of the digestive system
What is meant by minimally invasive cancer surgery?
The Surgical Oncology Minimally Invasive (Laparoscopic) is the border of the treatment of patients with a tumor, using techniques that preserve to the maximum the integrity of the organism, which in the past were reserved for patients with non-cancerous diseases.
In which cases is it indicated?
The area in which I have, for over 20 years, refined my expertise is the application of Laparoscopy on patients who have cancer of the digestive system , stomach, intestines and more. With the technologies we are equipped with at the Santa Maria Annunziata Hospital in Florence, recently updated with my arrival, we can safely apply to all young and elderly patients these techniques that allow you to remove the tumor and organ that has been involved, without long cuts on the abdomen. There are no particular contraindications.
What does the intervention consist of?
The surgery, performed under general anesthesia, involves the introduction of some cannulas equipped with a valve that cross the wall of the abdomen and the creation, with carbon dioxide, of a cavity, where, with miniaturized instruments, it is possible to perform the same operations that once, and still today, some surgeons who are not experienced in these techniques perform with disfiguring and painful cuts on the belly . These techniques are already very advantageous because they make it better to see, on large monitors and with very high resolutions compared to the naked eye, they are included in perioperative and postoperative protocols, which greatly facilitate patients.
Oncological laparoscopy: what is the ERAS protocol?
The protocol I have chosen, after over 15 years of practice and experience on my part (among the first to adopt it in Italy) is called ERAS. In English “Enhanced Recovery After Surgery” (Accelerated Recovery After Surgery ). The program allows to reduce the patient’s stress by avoiding putting the tube in the stomach, drainage in the belly, removing the bladder catheter quickly and starting to eat and walk the patient the day after surgery. In addition, preparations of the intestine are avoided with annoying purges, such as those that must be taken for colonoscopy. The minimally invasive laparoscopic techniques and the application of the ERAS protocol allow to reduce the pain of the intervention and to recover appetite and mobility forces in a few days, thus giving the possibility to return home, from one’s loved ones, very soon (after 4 or 5 days after surgery).
In short, I believe that all patients suffering from tumors of the digestive system should be operated in this way, safely and without stress induced by the intervention.