Colorectal Cancer Surgery
Surgery serves as the primary form of treatment for colorectal cancer. Our surgeons specialize in open and laparoscopic surgical removal of tumors, applying techniques focused on reducing the rate of local recurrence and improving survival rates. This also preserves the integrity of your bowel and minimize the need for a permanent colostomy. With modern techniques, having a permanent colostomy is rare.
Specialized surgical procedures include:
- Robotic colectomy
- Total mesorectal excision (TME) for rectal cancer
- Laparoscopic and open colon resection
- Rectal surgery
- Coloanal and "J pouch" construction
- Ileoanal pouch procedures
- Transanal excision
- Transanal endoscopic microsurgical excision (TEMS)
- When appropriate, liver resection for colorectal cancer that has spread to the liver
- Cryotherapy and radiofrequency ablation. Both percutaneous, open and laporoscopic
During this surgery, our physicians remove a section of the colon containing the cancer, as well as nearby lymph nodes. This can be done through an open, laparoscopic or HALS approach.
Hand-Assisted Laparoscopic Surgery (HALS)
This minimally invasive surgical approach requires only a few small incisions in your abdomen. A single long incision is required for traditional open surgery. Our surgeons insert a thin, lighted tube and tiny video camera to allow magnified views of the surgical site on a video monitor. A unique collapsible port holds open one of the small incisions in your abdomen. It fits around your surgeon's fingers, allowing access to your tumor site so the surgeon can cut and remove the cancerous section of the colon while the remaining colon segments are reconnected. Because your surgeon can grip and feel the tumor site, HALS provides tactile advantages over straight laparoscopic surgery that uses only surgical instruments.
HALS and straight laparascopic surgery vs. traditional open surgery
- Same time-tested results as open surgery
- Reduced blood loss and need for transfusions
- Decreased rate of wound infection
- Reduced pain
- Faster recovery and return to normal activities
- Less scarring
SILS (Single-Incision Laparoscopic Surgery): this laparoscopic surgery allows your surgeon to make only one small incision through your naval instead of the standard 4−6 small incisions used during traditional laparoscopic surgery.
Local resection is an option for some patients with stage I rectal cancer. The surgery can be done through your anus without an incision in the abdomen.
TEMS (Transanal endoscopic microsurgical excision)
This more advanced surgical technique uses special instruments that allows your surgeon to remove some tumors higher up in the rectum through the anus without an incision in your abdomen.
Low Anterior (LA) Resection
We use this surgery for cancers found in the upper and middle rectum. After surgery the colon is attached to the lower rectum and you can pass stool in the usual way.
Proctectomy with Coloanal Anastomosis/J-Pouch
This surgery is used for cancers in the lower part of the rectum. During this surgery, your surgeon removes your entire rectum and attaches the colon to your anus. A pouch is constructed (using part of the colon) allowing stool to pass in the normal way. TME (total mesorectal excision) will be used during this procedure, which allows your surgeon to remove rectal lymph nodes at risk for containing cancer. This helps to reduce your risk of local cancer recurrence and improves your survival.
Abdominoperineal (AP) resection
This surgery is used for cancers found in the lower part of your rectum. During this surgery, your surgeon removes your anus so you’ll need a permanent colostomy.
Using a technique similar to straight laparascopic surgery, this surgery uses special robitic instruments that allows for more controlled and finer movement when working in delicate areas of your pelvis. The robot allows your surgeon to perform more complex procedures with more precision.
New Surgical Techniques on the Horizon
NOTES (Natural Oriface Transluminal Endoscopic Surgery)
This is an evolving surgical technique that allows for an abdominal surgery to be performed without scars. The surgery is performed with a scope passed through a natural orifice (opening such as the mouth or vagina) to the desired organ. There are no external incisions or scars.