Robotic Surgery Specialist In Bozeman, Montana

What is robotic surgery?

Robotic surgery is an advanced form of minimally invasive surgery in which the surgeon controls specialized instruments from a console in the operating room.

The robotic system does not perform the operation independently. Every movement of the instruments is directed by the surgeon in real time.

The da Vinci system provides a highly magnified three-dimensional view of the surgical field and uses wristed instruments that move with greater freedom than conventional straight laparoscopic instruments. This allows the surgeon to perform precise dissection, suturing, and reconstruction deep within the abdomen and pelvis.

The da Vinci 5 system is Intuitive’s most advanced multiport robotic platform. It incorporates enhanced three-dimensional visualization, advanced instrumentation, force-feedback capability, and integrated surgical data technology.

What are the advantages of robotic colorectal surgery?

Robotic surgery offer several advantages over open surgery, including:

• Smaller abdominal incisions
• Less postoperative pain
• Reduced blood loss
• Lower risk of wound complications
• Shorter hospitalization
• Faster return to normal activity
• Lower likelihood of conversion to an open operation in selected complex cases

Compared with conventional laparoscopy, robotics provides the surgeon with improved instrument articulation, stable three-dimensional visualization, and greater control when operating in narrow or difficult anatomy.

Robotic and laparoscopic surgery can both produce excellent results. The principal advantage of the robotic platform is that it enables an experienced surgeon to perform more of the operation entirely inside the abdomen, including complex dissection, suturing, and creation of the bowel connection (anastomosis).

Although current comparative evidence does not show that the robot alone guarantees fewer complications than laparoscopy,² the robotic platform is the preferred surgical instrument for many colon and rectal surgeons. Outcomes depend heavily on the disease being treated, the operation, patient factors, and the surgeon’s experience.

How is robotic surgery used in colorectal procedures?

Dr. Zehnpfennig uses robotic surgery to treat:

• Colon and rectal cancer
• Diverticulitis
• Inflammatory bowel disease
• Rectal prolapse
• Colostomy reversal
• Complex pelvic and reoperative colorectal conditions
• Selected rectal tumors treated through a transanal approach

During robotic colon and rectal surgery, the dissection, blood-vessel control, bowel division, and anastomosis can be completed entirely inside the abdomen.

This fully intracorporeal approach allows Dr. Zehnpfennig to choose the safest and least traumatic method of specimen removal rather than designing the operation around a large extraction incision.

What is natural-orifice specimen extraction?

In conventional minimally invasive colon surgery, several small ports are used for the operation, but an additional larger abdominal incision is usually made to remove the specimen and prepare the bowel for the anastomosis.

Natural-orifice specimen extraction, or NOSE, allows the removed segment of colon to be delivered through the anus or vagina rather than through a larger abdominal extraction incision.

Dr. Zehnpfennig has extensive experience with this technique. For patients undergoing elective surgery for diverticulitis, natural-orifice extraction is feasible in nearly every patient. For cancer surgery, eligibility depends on the size and characteristics of the specimen and whether it can be removed intact without compromising oncologic principles.

Compared with conventional abdominal specimen extraction, robotic natural-orifice surgery is associated with less postoperative pain, fewer wound infections, faster return of bowel function, and shorter hospitalization.¹˒³

What happens when natural-orifice extraction is not appropriate?

When the specimen cannot be safely removed through a natural orifice, the robotic approach still allows Dr. Zehnpfennig to complete the operation and bowel reconstruction inside the abdomen.

He can then place the extraction incision in the location that offers the best balance of safety, exposure, comfort, and reduced risk of an incisional hernia.

Why does surgeon experience matter?

The robot is an instrument. Results depend on the surgeon controlling it.

Dr. Zehnpfennig completed nearly all of his colorectal fellowship operations using the da Vinci Xi platform and has now performed more than 1,000 robotic procedures. His practice focuses on advanced robotic colon and rectal surgery, natural-orifice specimen extraction, and enhanced recovery.

He also tracks his operative results and discusses relevant outcome data openly with patients. This allows patients to evaluate not only the proposed technology, but the experience and performance of the surgeon using it.

1. Cao L, et al. Evaluation of the efficacy of natural orifice specimen extraction surgery versus conventional laparoscopic surgery for colorectal cancers: a systematic review and meta-analysis. Colorectal Disease. 2025.
2. Thrikandiyur A, et al. Robotic versus laparoscopic surgery for colorectal disease: a systematic review, meta-analysis and meta-regression of randomized controlled trials. Ann R Coll Surg Engl. 2024;106:658–671.
3. Huang L, Wang JQ. Comparative analysis of natural-orifice and conventional transabdominal specimen extraction in robot-assisted colorectal cancer resection: a systematic review and meta-analysis. J Robot Surg. 2024;18:360.