Colorectal Cancer Health Center
Surgery to Treat Colorectal Cancer
Until recently, all bowel or intestinal surgery was done through long abdominal incisions, which resulted in a painful and lengthy recovery. In 1990, doctors started using a laparoscope, an instrument used primarily to treat gynecological problems and gallbladder disease, to perform certain types of bowel surgery. Rather than making long incisions common in traditional "open" surgery, laparoscopic surgery requires only small incisions to perform the operation.
What Is Laparoscopic Surgery?
The word "laparoscopy" means to look inside the abdominal cavity with a special camera or scope. To perform laparoscopy, 5 or 6 small (5-10 mm) incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these small incisions. The surgeon is then guided by the laparoscope, which transmits a picture of the intestinal organs on a video monitor.
The benefit of using this surgical approach is that you will likely experience less pain and scarring after surgery, a more rapid recovery and less risk of infection.
Colorectal surgeons have used laparoscopy to treat the following conditions:
- Crohn's disease
- Certain colorectal cancers
- Diverticulitis
- Familial polyposis
- Fecal incontinence
- Rectal prolapse
- Ulcerative colitis
Terms You May Hear Your Doctors Use When Talking About Colorectal Cancer Surgery.
- Polypectomy is a procedure in which polyps -- small growths on the inner lining of the colon -- are removed during a colonoscopy, a procedure in which a special instrument (the colonoscope) is inserted into the rectum to view the rectum and colon.
- Local excision is used to treat cancers in the lowest part of the colon, the rectum. The procedure involves removing the cancer and some tissue of the wall of the rectum. It may be done through the anus, the opening of the rectum or through a small cut in the rectum. The procedure does not require major abdominal surgery.
- Resection involves the removal of part, or all, of the colon along with the cancer and its attaching tissues.
Surgical Options for Colorectal Cancer
- Partial colectomy. As the name suggests, this is when the surgeon removes only part of the colon. The remaining parts will be joined together in a procedure that doctors call anastomosis. If you have a partial colectomy, then your bowel habits should go back to being pretty much the way they were before you had the cancer.
- Right colectomy, or Ileocolectomy. During a right colectomy, the right side of the colon is removed. During an ileocolectomy, the last segment of the small intestine that's attached to the right side of the colon, called the ileum, is also removed.
- Abdominoperineal resection . This is an operation in which the anus, rectum and sigmoid colon are removed.
- Proctosigmoidectomy . In this operation, the diseased section of the rectum and sigmoid colon is removed.
- Total abdominal colectomy . A total abdominal colectomy is an operation that removes the entire colon but preserves the rectum and anus.
- Total proctocolectomy. This is the most extensive bowel operation performed and involves the removal of both the rectum and the colon. If the surgeon is able to leave the anus and it works properly then sometimes an ileal pouch (see below) can be created so that you can go to the bathroom as you did before you had cancer. However, often a permanent ileostomy (see below) is needed particularly if the anus must be removed, is weak, or has been damaged.
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