When Gastric Cancer Struck, Robotic Surgery Delivered Hope to Roberto

Six days before Roberto Tellez was scheduled to see his local primary care provider in Tallahassee, a routine order for laboratory testing set in motion a cascade of events that would ultimately alter the course of his life.

“At that time, I had so much trouble going to the bathroom, and I had to use a major laxative,” said Roberto, a 62-year-old maintenance worker for the state of Florida. “And when everything came out, everything was black as tar.”

The finding and the subsequent appointment confirmed clinicians’ concerns. Blood work revealed significant irregularities, and imaging and evaluation identified a large gastric ulcer.

In September 2024, his local physicians ordered an upper endoscopy that nearly proved catastrophic. During the procedure, physicians identified gastric polyps and attempted to remove them. The intervention was unsuccessful and precipitated a hemorrhage, requiring emergent transport by ambulance to the hospital.

“Of course, I didn’t know what was going on because I was still under anesthesia,” Roberto said. “When I realized where I was, I was riding in an ambulance to the hospital. I spent four days there without food, only water. That’s what it took before the doctor saw me and told me that everything was OK and I could eat again.”

But everything was not OK.

Two months later, on Nov. 6, 2024, Roberto returned to the clinic with his wife for a follow-up appointment that would redefine his future.

“Out of the blue, the doctor says, ‘Roberto, I’m sorry. You have cancer,’” he said. “And when somebody tells you something like that … I didn’t know what to say or what to think. It was so horrible.”

The diagnosis was gastric cancer — a disease that often presents late and carries significant morbidity and mortality. Roberto promptly shed the shock of the devastating diagnosis and took steps to beat his cancer. He understood that definitive management would require surgery, and his wife urged him to seek care at a place she trusted.

That place was about a two-hour drive south.

“My wife said, ‘Shands. Let’s go to Shands,’” he said, referring to UF Health Shands Hospital in Gainesville. “I said, ‘Yeah, we want a specialist. I want someone who knows what to do.’ Because my wife had previous surgeries there, and they have a perfect hospital for cancer treatment.”

Roberto contacted UF Health and was scheduled for an early December consultation with Ibrahim Nassour, MD, a surgical oncologist who has spent his career developing UF Health’s robotic surgical oncology program.

Before finalizing a treatment plan, the UF Health team repeated diagnostic testing to confirm the extent of the disease. An esophagogastroduodenoscopy confirmed Stage 2 gastric cancer. Importantly, staging studies showed no evidence of metastatic spread beyond the stomach.

Dr. Nassour explained that Roberto would require a robotic subtotal gastrectomy — an operation that involves resection of approximately 80% of the stomach, followed by reconstruction to restore gastrointestinal continuity.

Using a robotic platform, the surgeon would remove the diseased portion of the stomach and reconnect the remaining stomach to the small bowel. The approach reflects a growing international interest in robotic techniques for gastric cancer, particularly in centers with advanced expertise.

“The benefits of robotic surgery include enhanced precision and dexterity, with wristed instruments that have seven degrees of freedom to allow fine dissection and suturing, especially in confined spaces like the pelvis, hiatus and pancreas,” Dr. Nassour said. “It also offers superior visualization in the form of a high-definition, 3D-magnified view that improves identification of critical structures like vessels, nerves and planes.”

For surgeons, the platform also offers improved ergonomics. For patients, robotic gastrectomy confers many of the benefits of minimally invasive surgery: smaller incisions, reduced blood loss, less postoperative pain, shorter hospital stays and faster functional recovery.

On March 4, Roberto underwent the procedure at UF Health Surgical Specialists – Shands Hospital. The operation was successful.

The emotional peak came when he was told that not only had his pain resolved, but there was no visible evidence of cancer.

“I felt like I was born again,” an emotional Roberto recalled. “I was brand new. At that time, nothing else mattered but to go back to family and enjoy life.”

For Dr. Nassour, outcomes like Roberto’s exemplify how uniquely meaningful surgical oncology is: It’s about giving patients time — enough to return to their families, their careers and the lives they feared they might lose.

“The greatest fulfillment comes from knowing that what we do can fundamentally change the trajectory of a patient’s life,” Dr. Nassour said. “For a cancer patient, surgery is often the defining moment — the point where hope becomes tangible. Being able to remove the cancer, offer a chance at a cure and tell a patient and their family that there is no visible disease is incredibly powerful.”

He continues to undergo follow-up visits and routine surveillance imaging, but he approaches this new chapter in life he’s been gifted with gratitude.

“The people (at UF Health) are so nice, so attentive,” he said. “Anything you ask, they have answers. When it comes to that part of the care, man, I felt special. Everything was so great.”

Beyond individual patient care, Dr. Nassour remains committed to advancing the field. As part of the Florida Cancer Innovation Fund, he recently signed an agreement for a $1.4 million grant in cooperation with Mount Sinai aimed at improving gastric cancer treatment and outcomes.

“Even when a cure is not possible, helping patients live longer, better and with dignity is profoundly fulfilling,” Dr. Nassour said. “Knowing that your expertise, precision and compassion can directly translate into survival and quality of life is what motivates me every day.”