Discover how Roswell Park Comprehensive Cancer Center is transforming GI cancer care with cutting-edge advancements in minimally invasive robotic surgery, innovative hepatic artery pump therapy, and multidisciplinary treatment for recurrent rectal cancer.
From achieving one of the nation’s lowest anastomotic leak rates to pioneering localized chemotherapy that minimizes toxicity, our expert team leverages state-of-the-art technology, AI-driven precision, and decades of high-volume experience.
Watch as Dr. Moshim Kukar highlights how these breakthroughs, supported by seamless team collaboration and virtual consultation options, are redefining outcomes for patients with complex GI malignancies.
Hi, my name is Marsha Kukar. I'm the Chair of Surgical Oncology and the program director of Complex Jones Surgical Oncology Fellowship here of Roswell Park Comprehensive Cancer Center as a Chair of Surgical Oncology. I'm really excited to share some of the advances in the field of G I surgery. In the last two decades, we have seen the evolution from open surgery to now minimal invasive surgery techniques, which was initially laparoscopic, which is operating with sticks to now robotic surgery that leads to us doing really complex procedures that last anywhere from 4 to 10 hours. And we can accomplish this with a lot of precision while reducing complications, reducing the length of stay and then improving the quality of life of patients. I'm really excited to share three advances in the field of uh G I surgery. The first one is uh the robotics in the mis program that we built here at Roswell Park in partners with our thoracic colleagues. We're actually one of the highest volume robotic assisted esophagectomy and gastrectomy programs in the country. Our most recent published data shows that we have achieved an anastomotic leak rate of 1% which is where we connect these es to the stomach. Whereas the national data shows that this number ranges from anywhere from 8 to 25%. We're also one of the few centers outside of New York City that offers robotic assisted approaches to pancreas and liver tumors where we can actually preserve function of the pancreas. And we can also preserve function of the liver prin as well. In addition, we also offer complex approaches where we can resect portion of arteries and veins that are wrapping around these tumors that sometimes requires a multi team approach to be able to uh accomplish this complex procedures. We also have a very mature colorectal surgery program lasting over a decade here and the team has performed more rectal surgeries than any other center in Western New York. So the second advancement I wanna talk about is our hepatic artery pump program. And under the leadership of Doctor Benjamin Calvo, Doctor Leonard Turas and Doctor Anu Krishna Murthy, we have started this program last year and now have done about 10 hepatic artery pumps. These pumps are these catheters that are surgically placed inside the hepatic artery that supplies blood to the liver. So we can deliver very specific chemotherapy agents to the liver without affecting the other parts of the body. Now, this approach is offered to patients that have a lot of liver tumor burden. They have multiple small tumors or big tumors that cannot be removed safely removed surgically So, the intent of chemotherapy is to really shrink these tumors to either make them receptible that we can take them out or we can offer a survival benefit that the patients can live with these tumors without much progression for a longer period of time. By delivering just the key therapy to deliver, we can either offer them a curative option, cure them or prolong their life without causing them significant toxicity of prolonged chemotherapy. The third advancement I wanna talk about is our recurrent rectal cancer program. Our colorectal surgery team includes Doctor Dakwar, Doctor Man, Doctor Calvo, under the leadership of Doctor Nan leads this multidisciplinary program that offers options to patients that have had their rectal cancers removed on the outside and then the cancer comes back in that same place. And this cancer can then grow into local structures such as the bladder, the bone, which is the tail bone. We know that from statistics, about 10% of patients that have rectal cancer surgery will have their cancers come back in the pelvis. This is one of the programs again that requires a multidisciplinary team approach, including urologists that treat the bladder, the colorectal surgery, sometimes even an orthopedic surgeon that works on the tail bone and a plastic surgeon to get these patients safely through these procedures. The way this field is moving now, uh we are really have the ability to identify high risk populations that are at risk of developing these cancers. We can, we have good effective screening methods to screen them so that we can pick up early cancers and we can offer them less invasive approaches to, to manage these tumors utilizing uh artificial intelligence and machine learning. Uh These robotic uh platforms are becoming more sophisticated where we should be able to identify uh with a little bit more granularity, blood vessels, nerves and other structures that we can minimize the morbidity to the patients and minimize the publications as well. We at Roswell have a unique advantage given our high volume experience over a couple of decades, with these technologies that we can actually take a leadership role in the development of some of these technologies that are going to be in the forefront in the next decade. Another important aspect that I wanted to point out is the uh rapid evolution of uh systemic therapies that are available now including targeted therapies, immunotherapy, obviously, uh chemotherapies and and true sequencing of these therapies with surgery. There are times when utilizing surgery uh up front where whereas there are times where we're utilizing a combination of these therapies before we actually get to surgery with these complex operations. The volume outcome relationship is pretty well established. It's a very simple thing, the more you do, the better you get. And it's not just from a physician's perspective in terms of the technicality inside the operating room. This is truly a multidisciplinary team approach. It's the anesthesiology team in the operating room. It's the critical care team that's taking care of the post patients, postoperatively, the nursing team that knows these procedures in and out that determines the success of this program. In addition, we also have excellent help from our interventional radiology colleagues where we can accomplish procedures that otherwise would have required large incisions and then also our help from our interventional gastroenterology colleagues. So having all of these services under one umbrella is the key to success for these programs. If you have a patient with G I malignancy, uh we would strongly urge you to uh consider getting an opinion of Roswell Park. These opinions are also available virtually. Uh One of our physicians can offer advice virtually to the patients without the need of travel. And if we have any additional treatments or therapies that we can offer these patients, that we can arrange to see them at Roswell Park.
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