Colon and Rectal Cancer

As often as possible, Digestive Health Institute's colon and rectal surgeons perform minimally invasive surgery for certain colorectal cancers. Laparoscopic surgery involves special instruments that allow a colorectal surgeon to perform some operations through three to five very small incisions the size of keyholes. Some colorectal surgeries are performed with the assistance of a robotic surgical system that allows them to be minimally invasive procedures.

While minimally invasive colorectal surgery is not right for every patient, some patients can benefit from it. These benefits include less pain, less time spent in the hospital, a faster recovery and a decreased chance for complications after the surgery compared to a traditional open procedure. These benefits can sometimes allow patients to begin their next stage of cancer treatment sooner.

The following procedures are used to treat colorectal cancers. In the right situations, the Digestive Health Institute colorectal surgeons can offer them minimally invasively:

• Colectomy (Colon Resection) – A colectomy involves removing part of all of the colon as well as nearby lymph nodes. Usually only the part of the colon affected by cancer is removed, which can be about one-third of the colon. However, if the rest of the colon has many polyps or is affected by another condition such as inflammatory bowel disease, then it might be completely removed. Having a minimally invasive colectomy from a Digestive Health Institute surgeon experienced in this approach can shorten recovery time.
• Proctectomy (Rectal Resection) – If you have rectal cancer, then surgery to remove some or all of the rectum will often be needed. This is called a proctectomy or rectal resection. The rectum consists of the last six inches of the large intestine between the colon and the anus. Depending on the exact location, size of the tumor and how deeply is has spread into the intestinal wall, minimally invasive proctectomy may be done laparoscopically or as a transanal endoscopic microsurgery. This latter procedure does not involve any external scars. Instead, a very thin endoscope and other surgical tools can be inserted through the body’s natural opening at the anus.
• Proctocolectomy (Colorectal Resection) – In some cases, patients will need the colon, rectum and anus removed to best treat cancer, a procedure called proctocolectomy. Before proceeding with this approach, Digestive Health Institute colorectal surgeons will explore other options that may preserve the rectum and anus. This procedure is followed by either J-pouch surgery or an ileostomy so the body has a new way to store and release solid waste. A proctocolectomy is a very complex surgery. While our surgeons have experience performing it minimally invasively, it may sometimes require an open procedure.
• Abdominoperineal Resection for Rectal Cancer – An abdominoperineal resection involves removing the anus, rectum and part of the sigmoid colon to stop or reduce the spread of rectal cancer. Nearby lymph nodes may also be removed. Even though it is an extensive procedure, the Digestive Health Institute surgeons are experienced in performing it as a minimally invasive procedure, either as laparoscopic or robotic-assisted surgery. Abdominoperineal resection requires a colostomy, in which the bottom of the intestine is connected to an opening in the abdomen so waste can exit the body. Having a permanent colostomy will understandably change a patient’s lifestyle. Therefore, Digestive Health Institute surgeons first consider sphincter-sparing surgery alternatives for patients with rectal cancer who have been referred for an abdominoperineal resection.
• Pelvic Exenteration – In rare cases, colorectal cancer requires the removal of nearby organs in a procedure called a pelvic exenteration. The surgeon might need to remove the bladder and/or prostate or uterus if these organs are affected by colorectal cancer.