Colorectal Cancer Surgery
What Is Laparoscopic Surgery?
Until recently, all bowel or intestinal surgery was done through long abdominal incisions, which often resulted in a painful and lengthy recovery. In the early 1990s, doctors started using a laparoscope, an instrument that had primarily been used 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 same operation. Another type of laparoscopic surgery is called hand-assisted and allows for one of the surgeons hands to be inserted into the abdominal cavity while still viewing the procedure with the laparoscope.
The benefit of using a laparoscopic approach is that you will likely experience less pain and scarring after surgery, a more rapid recovery, and less risk of infection than with an open surgery through a large incision.
Colorectal surgeons have used laparoscopy to treat the following conditions:
- Crohn's disease
- Colon cancers
- Familial polyposis
- Certain colon polyps that cannot be removed by colonoscopy
- Fecal incontinence
- Rectal prolapse
- Ulcerative colitis
- Certain rectal cancers
Surgery Options for Colorectal Cancer
There are several types of surgery which may be used to treat 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 anastamosis. 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 - which is 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. A permanent colostomy is required, as the anus is 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 large intestine.
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.