Removing cancer by surgery is a common first step for patients with colon cancer, and a possible second step after chemotherapy for patients with rectal cancer.
Our surgeons perform more than 90% of colon and rectal surgeries with minimally invasive techniques such as laparoscopic or robotic procedures. These advanced approaches offer patients several benefits over traditional, open surgery, including:
- Smaller incisions that heal faster with less scarring
- Less pain
- Shorter hospital stay
- Faster recovery
To treat your cancer, our colorectal surgeons may recommend one of the following procedures:
- Colectomy removes the portion of the colon containing cancer and reconnects the healthy portions back together. How much of the colon is removed depends on your blood supply, the drainage patterns of your lymph nodes, the tumor’s location and the extent of your disease.
- Colostomy creates a new path for waste to leave the body through the abdominal wall into a colostomy bag, a plastic pouch worn outside the body. This allows the colon and rectum time to heal after surgery to remove the cancer. For most of our patients, the colostomy is temporary and can be reversed with another small surgical procedure.
- Proctectomy removes all or part of the rectum, the last 6 inches of the large intestine. How much of the rectum is removed depends on your tumor's location and extend of your disease.
- Transanal minimally invasive surgery (TAMIS) is performed through the anus for early-stage rectal tumors, or for patients who have other health conditions that make other surgery types too risky for them. Roswell Park is one of few facilities that performs this procedure with robotics, called robotic transanal minimally invasive surgery (rTAMIS), taking the surgical precision to a higher level.
- Endoscopic mucosal resection (EMR) is a minimally-invasive procedure performed through an endoscope to remove early tumors of the colon or rectum.
- Lymph node surgery remove the lymph nodes near the portion of the colon or rectum that is removed. These lymph nodes must be analyzed properly to determine whether they contain any cancer cells. Cancer that has spread to lymph nodes means you’ll likely need other treatment beyond surgery, such as chemotherapy.
- Total Mesorectal Excision (TME) is a critical procedure for patients with rectal cancer. This surgery removes the rectum along with the surrounding lymphatic tissue, called the mesorectum. Ensuring complete removal by a skilled surgeon is essential to reduce risk for recurrent cancer.
A colostomy bag, also known as an ostomy bag, ileostomy bag, or stoma bag, is a small, waterproof plastic pouch used to collect waste from the body.
During a surgical procedure known as a colostomy, an opening – called a stoma – is formed between the large intestine (colon) and the abdominal wall. The colostomy bag can then collect stool as it passes through the gastrointestinal tract.
When surgeons need to remove a section of the colon or rectum to effectively remove all the cancer, sometimes reconnecting the healthy parts of the colon isn’t possible.
In these cases, the surgeon creates a new path for waste to leave the body through an opening (stoma) in the wall of the abdomen. Waste is collected in a flat pouch worn outside of the body. The operation to create a stoma from the large intestine — the colon — is called a colostomy. Creating a stoma from the small intestine is called an ileostomy.
For most people, this stoma is temporary. Once the colon or rectum heals, the surgeon can reconnect the healthy portions and close the stoma. For some rectal cancer patients, especially those who undergo chemotherapy and radiation prior to surgery, a temporary loop ileostomy will be in place for several weeks to allow healing time and completion of other therapy. When the time is right, the ileostomy is removed with another small surgical procedure. Learn more about ostomy reversal.
Whether or not a colostomy is permanent depends on the cancer’s stage and how close the tumor is located to the muscles that control bowel movements (the sphincter muscles) and how well these muscles function prior to surgery. In certain rectal cancers, chemotherapy and radiation treatment before surgery may reduce the need for a permanent colostomy. However, for some patients, such as those who suffer incontinence, a colostomy can improve quality of life.
Roswell Park performs a high volume of these complex surgeries and a high number of our patients avoid a permanent colostomy.
Highlights of our surgical expertise
We offer less invasive, advanced surgical options that result in better outcomes and quality of life for years to come.
- High volume proficiency. Roswell Park has performed more than 1,500 robotic colorectal surgery procedures, including more than 200 colectomies, and treats more than 100 rectal cancer patients each year.
- Better chance to maintain normal bowel function. Our surgical experience and mastery of robotic techniques help most patients maintain normal bowel function, avoid a colostomy, and return to normal life more quickly — without compromising survival.
- Better outcomes, expert care. We achieve outcomes significantly better than the national average, resulting in recognition as High Performing in Colon Cancer Surgery by U.S. News & World Report.
Can you avoid a colorectal operation?
We offer advanced endoscopic procedures (similar to a colonoscopy) and many patients with early-stage disease may have their tumor removed without an operation.
