The World Renowned Robotic Gynae Surgeon Dr. Ricardo Estape on Beyond the Scalpel with Dr. Alrashid

Gynecologic Cancer, Robotic Surgery & the Future of Women's Healthcare | Dr. Ricardo Estape

What does the future of women's cancer care look like and how is robotic surgery transforming outcomes for patients around the world?

In this compelling episode of Beyond the Scalpel with Dr. Mamun AlRashid, Dr. AlRashid sits down with Dr. Ricardo Estape, one of the nation's leading gynecologic oncologists and a pioneer in robotic surgery. Having performed more than 11,000 robotic gynecologic procedures, Dr. Estape shares his remarkable journey from choosing a career in medicine to becoming a global leader in the treatment of ovarian, uterine, cervical, and other gynecological cancers.

Together, they explore the latest breakthroughs in early cancer detection, targeted therapies, personalized medicine, and how multidisciplinary care is improving survivorship for women diagnosed with cancer. Dr. Estape also provides fascinating insights into the evolution of robotic surgery, compares robotic and laparoscopic techniques, discusses the future of autonomous and remote surgery, and shares invaluable advice for the next generation of surgeons.

Whether you're a physician, healthcare professional, medical student, or someone interested in the future of cancer care and surgical innovation, this conversation offers an inspiring look at where medicine is headed.

In this episode, you'll discover:

• How compassionate communication shapes the patient experience after a cancer diagnosis
• The latest advances in early detection of gynecologic cancers
• Why targeted therapies and personalized medicine are changing oncology
• How robotic surgery is redefining surgical precision and patient recovery
• The future of autonomous surgery and telesurgery
• Leadership lessons from one of the world's most experienced robotic surgeons

Chapters
00:00 Introduction to Dr. Ricardo Gestape
02:03 Journey into Medicine and Gynecological Oncology
05:30 Approaching Difficult Diagnoses in Women's Cancer
07:36 Advancements in Early Detection of Gynecological Cancers
10:22 The Role of Primary Care in Cancer Detection
11:59 Progress in Targeted Therapies and Personalized Medicine
15:37 Improving Access to New Treatments in South Florida
17:27 Toxicity Profiles of New Cancer Treatments
19:09 Factors Improving Cancer Survivorship
21:15 The Evolution of Robotic Surgery
27:27 Comparing Laparoscopic and Robotic Surgery Outcomes
28:41 The Evolution of Robotic Surgery
30:38 Oncology and Surgical Outcomes
32:33 Advancements in Robotic Technology
36:24 The Future of Autonomous Surgery
38:06 Telesurgery: A New Frontier
43:00 Training the Next Generation of Surgeons
48:24 Reflections on a Surgical Career
50:44 Healthcare Policy and Advocacy
54:30 Rapid Fire Round: Insights and Reflections

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Disclaimer: The views and opinions expressed by our guests are their own and do not necessarily reflect the views of Beyond the Scalpel, Dr. Mamun AlRashid, or its affiliated organizations. This podcast is intended for educational and informational purposes only and should not be considered medical advice.

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Transcript

Dr. Mamun Alrashid
Okay, my guest today is one of the most accomplished gyne oncology surgeons in the country, and I'm one of the most important voices in women's cancer care. Dr. Ricardo Gestape is a board-certified gynecologist with decades of experience treating some of the most complex and life-threatening cancers a woman can face: ovarian, uterine, cervical, and beyond. He is a pioneer in robotic surgery.

And he has done over 11,000 gynecological robotic surgeries. He started the robotic programs at Baptist Health, South Florida, Larkin Hospitals, and now building a gynecology and robotics program for HCA Florida across 17 hospitals. He has built a distinguished clinical career right here in South Florida, contributing to research, training.

And setting a high standard of care that women across this region can come to depend on. But what strikes me most about Dr. Gestape is that behind all the accolades is a physician who shows up for his patients every day at the hardest moments of their lives. And that to me is what practicing medicine at the highest level is all about. Dr. Ricardo Estape, welcome to Beyond the Scalp.

Thank you so much, Dr. Stope. So let's start right at the beginning. Let's get to know the young Ricardo and how you discovered your calling to medicine and then gynecological oncology, which is a very, very tough emotional area of expertise.

And then how did you venture into ⁓ oncology or oncological treatment?

That's awesome. That's awesome. So let's go into a little bit about your area. women's cancer, pretty much, right? Now it's a it's a tough, tough diagnosis for many women to swallow and the conversation can be very difficult. so how do you how do you approach that as a seasoned clinician who's seeing thousands of patients when when you're kind of really disclosing that first diagnosis to them?

Right, right. And so you mentioned about screening, Dr. Stape. I know that some of these gynecological cancers can be very challenging in terms of early detection. I think ovarian being a common one. Just walk us through what advancements have there been in some of those challenging early detection cases.

Yeah, yeah, absolutely. No problem.

Yeah, we can just ⁓ just yeah, you can just c start start at the beginning if you like in terms of

And is there any discussions that you have when you're discussing with primary care doctors who are really at the forefront when these women present that you you kind of tell them to pick up or be aware of or or any advice that you give them?

Right. So sort of keeping with that, I know w we're gonna discuss the surgical side, but just ⁓ in terms of what you would consider meaningful progress in targeted therapies, chemo, immunotherapy, what are you mostly optimistic about? What do you what have you feel that may have been really, you know, have been game changers?

Awesome. And is there any particular subtype of cancer that you're you're particularly seeing very good results on with this?

So it's it seems that there's more precision in terms of of of these targeted therapy and also kind of really customizing it to the individual's genetic makeup so that it's more effective. but ⁓ how from a you you mentioned that you know we have a challenging South Florida demographics, how accessible are these new treatments for for the South Florida community?

That's that's good to hear. I think the community will will will be pleased to know that. And just to staying on that, ⁓ are you noticing that because of the the the precision, is the is the toxicity profile also improving?

So in terms of, and you've alluded to it a little bit, the survivorship data. And I know there's different components, and a lot of times these complex care, these cancer patients have to be managed in a multidisciplinary setting with multiple specialties coming in. Obviously, you as a surgeon play a very key role in removing the tumor, and then these you know, adjunctive treatments are then kind of ⁓ helping with the survivorship. What would you say over your

over lifetime of practice in this field have been really significant factors in improving survivorship.

Awesome. So Dr. Stope, let's talk about ⁓ robotic surgery. I mean, you're a pioneer, you're a at the the peak of of of robotic surgery in this country and if not in the world. take us through your mindset, how you came to become an early adopter, what convinced you that this was the way forward, and what sort of resistance or reactions did you get from your colleagues when you first started?

So just for our audience, what what would you say are the the notable outcome differences between laparoscopic and robotics?

Nice, nice. I mean and in terms of ⁓ say the specifics in in relation to oncology, is there any data in terms of recurrence rates, ⁓ laparoscopic versus robotics?

Dr. Ricardo Estape
robotically.

were done by Jen.

Dr. Mamun Alrashid
Nice. So Dr. Ostapa, you've been also on the design side. You've you've you've got an engineering background and and you know, dealing with this machines that like most machines, they go through different iterations. Just tell us a little bit about what are you seeing and what are you noticing these different iterations or the evolution of the Da Vinci plat platform, for example.

And do you see this technology evolving as a lot of people who are at the forefront of technology? ⁓ let's name drop Elon Musk, who speaks of autonomous robots taking it to a next level where ⁓ you know the the robot w is not going to need a surgical guidance. Do you see that kind of trajectory?

And and the other thing that's obviously ⁓ got a lot of attention in the press is using the the robotic platform to do remote surgery. So you're you're sitting somewhere in Miami and then you're operating completely a different part of the world in Africa using that. Te walk us through that a little bit and where do you see the utility there.

Dr. Ricardo Estape
Give it down.

Dr. Mamun Alrashid
Awesome. That's ⁓ exciting times ahead for sure. Yeah. With the technology. So let's let's kind of ⁓ pivot a little bit. I mean, you're a master surgeon, you're a pioneer, and you I'm sure you educate the next generation of surgeons. Now, with you know, adopting any technology, there's a learning curve. How do you guide and advise surgeons who want to become as proficient as you in robotics?

I mean, that's such inspiring advice. I mean and I think I mean I I I train residents too and and one of the key things, you know, which you've mentioned is you have to have versatility. You can't be just honed in and limited by one specific set of technology. You should be able to bail yourself out if there is an issue, a malfunction, and to be able to know and do all these different techniques is is I think what makes you a truly rounded surgeon.

I mean, that's really awesome advice. And so is there any specific qualities that you look for in your resident and fellows that you you kind of say, well, this is what you need to be honing on and on focusing?

Awesome. So let's kind of hone in a little bit about just leadership and and and reflection of your amazing career. What would you say you're mostly proud of and what question, if any, in gynecological oncology would you say still keeps you up at night?

And that's such a great principle to to really lead your life and career with. I mean, that's awesome. so just a little bit, Dr. Stape, beyond the operating room, in terms of the wider healthcare policy and advocacy that you're seeing evolving in women's cancers, is there anything that you've particularly helped influence or shape or particularly that you're watching?

You make such a great point that I think it's so important for fellow clinician colleagues to be engaged in health policy advocacy at whatever level, because that we're on the forefront, on the ground, in the trenches, and we're always thinking what's best for the patient and to be able to have that input to the decision makers and the policy ma policy makers is I think very critical going forward. Thank you for that, Dr. Stappy.

So let's just ⁓ we're gonna do a little bit of a fun round. It's called gonna be called rapid fire. Okay. So we're gonna see ⁓ without thinking too much, your riff reflex response to these questions. I think we've got a a few. So if you're ready, I'm gonna fire some questions and we'll see your response rate.

Okay. Robotic surgery are open. If you had to op ⁓ do one operation for the rest of your career.

What's the one piece of advice you'd give a woman who just got a gynecological cancer diagnosis today?

What's a book, podcast, or idea outside of medicine that's shaped how you think?

Who in medicine, living or historical, would you most want to scrub in with?

Fascinating, fascinating. And last question. What does it mean to be a physician in 2026? And what gets you out of the bed in the morning?

Dr. Ricardo Astape is a surgeon, an advocate for women fighting cancer, a great educator and teacher. Thank you so much for joining us today on Beyond the Scalpel. What an extraordinary journey. I mean, trem so much enthusiasm and passion. You you are a beacon for those who want to aspire to that same level of proficiency in robotic surgery, and you're definitely moving the needle for.

For women's cancer, thank so much.