Minimally Invasive Oncological Surgery Essen: Univ.-Prof. Dr Andreas Rink

Professor Dr Andreas Rink is a specialist in minimally invasive tumor surgery with a particular focus on treating colon and rectal tumors (colon carcinoma, rectal carcinoma), gastric and esophageal tumors (gastric carcinoma and esophageal carcinoma), and those of the liver and pancreas. He is the representative director of the hospital for general, visceral, and transplant surgery at the University Hospital Essen. In addition, he is a specialist in surgery, special visceral surgery, coloproctology, and surgical oncology.

Professor Rink and his team have made it their mission to achieve radical tumor removal with maximum sparing of the surrounding healthy tissue and under minimal stress to the body. This is achieved by using high-resolution cameras, the most subtle dissecting instruments, and surgical robots to apply various minimally invasive precision surgery techniques, ensuring optimal functional preservation and rapid recovery.

Expert in Minimally Invasive Tumor Surgery

For most tumors of the digestive organs, correctly carried out surgical removal is the decisive step for the healing of the disease. In addition, these interventions can increasingly be carried out minimally invasively, also known as keyhole surgeries. This involves making only a few millimeter-long incisions in the skin. The wide opening of the chest cavity or a complete abdominal incision is then no longer necessary.

Professor Dr Rink holds the professorship for minimally invasive oncological surgery at the Medical Faculty of the University of Duisburg-Essen. In addition to the surgery of tumors of the gastrointestinal tract, Professor Rink also focuses on tumors of the esophagus, liver, and pancreas and is engaged in tumor metastases in the peritoneum (peritoneal carcinomatosis). Furthermore, minimally invasive surgical procedures are sometimes used in complex interdisciplinary operations.

Minimally invasive surgery has various advantages, from the point of view of optimizing the chances of recovery and from the point of view of the patient's subjective perception of the stress caused by the surgery. The better cosmetic result is due to small scars that are often hardly visible after the procedure falls far into the background. Much more critical is the faster recovery due to less pain, faster onset of bowel activity, less blood loss, and the resulting consequence of getting healthy again quickly and thus shortening the duration of treatment in hospital.

The gentler surgical technique also has another advantage: The body's tumor defenses are less impaired by the surgery. The faster recovery means that any additional therapies that may be necessary can begin more quickly and may therefore be more effective. Overall, the duration of treatment is shortened if the stress caused by the surgery is low. In the case of many tumor diseases, current research findings suggest equally good and even better chances of recovery after minimally invasive surgery.

Specialist for Colorectal Cancer Surgery

Colorectal cancer is one of the most common cancers in Germany. More than 30% of tumors are located in the rectum and are referred to as rectal cancer. Therapeutically, surgery is of central importance, although radiation or drug treatment is also used in some cases. Tumor surgery on the rectum is called "total mesorectal excision" (TME). The rectum is removed in one "package" and its surrounding vascular and tissue structures. The surgery is challenging because there are many nerves and blood vessels in the surgical vessel that should be spared as much as possible.

Maintaining fecal continence and essential other functions of the surrounding organs, such as the bladder or the genitals, to maintain a good quality of life is of great importance to Professor Rink and his team. For this reason, Professor Rink and his team also operate on rectal tumors located close to the sphincter muscle in 80-90% of cases while preserving bowel continuity and continence. This is also achieved by using state-of-the-art minimally invasive surgical techniques, such as surgical robots (DaVinci system), transanal minimally invasive surgical procedures (TAMIS), and pelvic neuromonitoring to protect the nerve structures in the small pelvis. Rectal tumors are therefore almost exclusively operated on without a large abdominal incision.

The tumor can also be removed locally for tiny tumors at an early stage. This procedure can be performed minimally invasive transanal, which is very little stressful for the patient.

For colon tumors (colon carcinomas), minimally invasive surgical procedures are also used almost exclusively; the surgical robot (DaVinci system) is preferred for many tumor localizations. Similar to rectal tumors, the goal is to remove the tumor-bearing intestinal segment and the associated vascular and tissue structures. The surgery is referred to as complete mesocolic excision (CME). Tumor surgery of the colon, while preserving the rectum, has far less impact on bowel function than tumor surgery of the rectum. Therefore, the minimally invasive surgical technique primarily helps optimize safe tumor removal and minimize the stress of the procedure.

Minimally Invasive Surgery for Stomach and Esophageal Cancer

Early stomach tumors (gastric carcinomas) are primarily operated on; very early ones can sometimes be ablated during gastroscopy. Advanced gastric cancers are now usually treated with surgery and chemotherapy. However, complete removal of the tumor is a requirement for a cure, but the likelihood of this is increased by chemotherapy, which is usually administered before and after surgery.

Gastric carcinomas can also be operated on minimally invasively in most cases. Here, too, high-resolution cameras, fine dissection instruments, or surgical robots (DaVinci system) help remove the tumor entirely in the sense of a precision intervention while preserving all important surrounding structures and with minimal stress on the patient.

As with other minimally invasive surgeries, the technique speeds recovery and can shorten the length of hospital stay and the overall treatment time for the disease.

Minimally invasive surgical procedures are used almost exclusively for esophagus cancers (esophageal cancer). The esophagus is mainly localized in the thoracic cavity. In most cases, the tumor-bearing section of the esophagus, which must be removed along with the surrounding vascular and tissue structures, is replaced by the tubularly reshaped stomach. This implies that tumor surgery of the esophagus requires surgery in the abdominal and thoracic cavities. Several studies have shown that using minimally invasive surgical techniques reduces the risk of postoperative complications and presumably improves recovery chances. Using a minimally invasive approach, Professor Rink and his team operate on most esophageal cancers. This means that neither the abdominal cavity nor the chest cavity needs to be opened through a larger incision. A high-precision surgical robot (DaVinci system) is increasingly being used here as well.

For further information, please visit the website of the minimally invasive oncological surgery of the University Hospital Essen.