Dr. Giuseppe Spinoglio is a founder of Columbus Digestive and Colorectal Robotic Surgery Cente and also a pioneer of robotic surgery, which he has elected as his main clinical interest and research focus for the past 15 years after he started in 2004.
He has been and currently is the founder and director of national and international robotic surgery schools (SIC robotics school, EARCS European Academy of Colorectal Robotic Surgery), as well as partner, founder and president of robotic scientific societies (SRS, Society of Robotic Surgery, CRSA, Clinical Robotic Surgery Association; ISFGS, International Society of Fluorescence Guided Surgery).
Robotic abdominal surgery for the digestive tract mainly focuses on diseases of the colon & rectum, stomach, pancreas, and spleen (malignant, benign or inflammatory diseases).
The DaVinci robot allows to perform more precise and less traumatic surgery thanks to advanced technical benefits such as 10 x magnification, tremor filtration, computer-assisted 3D vision, motion scaling.
Among the many tools currently available, fluorescence imaging is the most frequently used, both to visualize bile ducts and check the response of organs to vitality testing, as well as to identify the lymph nodes to be removed in malignant tumors by creating an accurate lymph node map.
Colon and Rectal surgery:
Right colon: radical Right Hemicolectomy is performed with no trauma at all. The number of lymph nodes removed is superior to that allowed by other techniques in our experience. Dr. Spinoglio has developed this original technique of right hemicolectomy known as bottom-up procedure, which allows increased radicalism and less trauma. The technique was presented at the American College of Surgeons in an educational video.
Left colon: Left Hemicolectomy is performed very easily. The robot is particularly useful in tumors of the splenic flexure, where it allows to undertake organ-preservation surgery with extensive removal of lymph nodes.
In Complicated Diverticulitis with abscess and perforation, the robotic technique allows a more precise, safer and less traumatic intervention compared to other techniques.
Rectum: in the treatment of Rectal Cancer, the DaVinci surgical system allows radical surgery through total mesothelial excision (TME), with higher possibilities of preserving urogenital nerves. The ease of dissection up to the pelvic floor facilitates direct anastomoses with intestinal reconstruction as an alternative to permanent stoma.
The reconstruction of digestive continuity is carried out easily, with resumption of nutrition within 24 hours of surgery. Management of patients with Gastrointestinal Stromal Tumours – GISTs – is particularly facilitated.
The most commonly performed surgery in this case is Distal Pancreatectomy, which removes the body and tail of the pancreas. This often involves removing the spleen (Distal Spleno-Pancreasectomy) yet in a high number of cases the robot facilitates its preservation (spleen preserving distal pancreasectomy).
Another intervention eased by the robot is Ampullectomy, that is, the removal of the ampulla of Vater in benign tumors or in cases of initial degeneration. The reconstruction of the duodenum, bile duct and pancreatic duct is facilitated by the fine and precise movements of the robot and its 10 x magnification capabilities.
Single-site Cholecystectomy: Cholecystectomy through a single incision hole at the navel is a little traumatic method with a satisfactory aesthetic outcome, as a single access through the “umbilical scar” leaves no scars at all at the end of surgery. This technique was developed in 2011 by Dr. Spinoglio in a joint study with Prof. Morel from Geneva and Dr. Kostantinidis from Athens. Combined with the use of fluorescence imaging to visualize the biliary tract, this is regarded as the safest aesthetic surgery technique for the removal of the gallbladder.
Spleen and Adrenal Surgery:
The robot makes the removal of these organs extremely safe. It also allows partial removal of the spleen (Hemisplenectomy), with the opportunity to save half of it in benign diseases.