Minimally Invasive Colorectal Cancer
What are the minimally invasive surgical techniques for colorectal cancer?
Surgery for colorectal cancer may be performed using minimal access techniques such as laparoscopy and robotic surgery. These approaches help us perform the surgery via small incisions on the abdomen with oncological safety.
The techniques may be any of the following:
- Laparoscopic surgery
- Hand assisted laparoscopic surgery
- Single incision surgery
- Robotic surgery
What are the differences between the minimally invasive and open approach to surgery?
| Minimal Invasive surgery | Open Surgery |
|---|---|
| Small Incisions | Large Incisions |
| Minimal blood loss | More blood loss |
| Minimal post-operative pain | Significant post-operative pain |
| No difficulty in walking, coughing, exercising | Difficulty in walking, coughing , exercising |
| Early recovery of bowel function | Delayed bowel recovery |
| Shorter hospital stay | Longer hospital stay |
Is it safe to perform these
surgeries laparoscopically?
A valid fear in applying these techniques is about the oncological safety. Oncological safety is the ability to perform a cancer surgery that adheres to the prevailing surgical standards endorsed by experts and international guidelines. With proper training and experience this oncological safety can be achieved with laparoscopic and robotic surgeries as well. This has been proved with time and again by robust scientific research.
Is there any advantage of robotic surgery over laparoscopic surgery?
One of the largest randomised control trials investigating the same, the ROLARR trial suggested there may be advantage in obese individuals and narrow pelvic anatomy.
Are there any contraindication to minimally invasive surgery in colorectal cancer?
History of previous major abdominal surgery, the presence of peritoneal disease and medical conditions which prohibit inflating the abdomen for visual access are few of the contraindications for minimal access surgery
Extended Resections such as Posterior Exenterations and Total Exenterations may also be performed by minimal access surgery.
Do all patients who under rectal surgery require a diversion stoma?
No, a diversion stoma is generally performed if the individual has undergone surgery for ow rectal cancer, if surgery is performed after a course of radiation and if there are features of obstruction.