Minimally Invasive Surgery

Many diseases and conditions of the colon and rectum are treated surgically. A surgeon may use traditional (open) or minimally invasive techniques depending on the individual case.

Traditional colon and rectal surgery

In open abdominal surgeries, surgeons typically make an incision 6 to 12 inches in length. Incisions can cause considerable discomfort and lengthen the hospital stay. It also takes longer for patients to resume normal daily activities when they have open incisions.

Minimally invasive colon and rectal surgery

Minimally invasive approaches can be used to effectively treat a variety of common benign and malignant colon and rectal conditions. Advanced technologies eliminate the need for large incisions. Laparoscopic surgery is a specific type of surgery, but the term is often used for all minimally invasive surgical procedures.

Laparoscopic surgery: The surgeon makes several small incisions about one-half inch in size. During laparoscopic procedures, a camera attached to a thin metal telescope (laparoscope) is placed inside a single incision. The laparoscope allows the surgeon to view the inside of the abdomen on operating room monitors. To perform the surgery, small instruments are placed through other small incisions.

Laparoscopic-assisted surgery: This type of procedure is performed primarily laparoscopically and then completed through a small abdominal incision.

Hand-assisted laparoscopic surgery: During this procedure, a device is placed in an incision 2 to 3 inches in length. The surgeon inserts a hand through the incision to assist in performing the operation.

Single incision surgery or single site surgery: In this approach, both the laparoscope and operating instruments are passed through a single, small incision.

Robotic surgery or robotic-assisted surgery: Similar to standard laparoscopic surgery, this newer technique allows a surgeon to control a robot that moves the surgical instruments.

Benefits

Incisions are much smaller than those used in traditional surgery, so there is usually less post-surgery discomfort. Other potential benefits include:

  • Shorter hospital stays.

  • Reduced prescription pain medications.

  • Earlier return to normal activities.

  • Less visible scarring.

It is important to note that long-term outcomes are similar between open and minimally invasive procedures. However, minimally invasive surgery offers potential benefits in the early post-surgery recovery period.

Risks

Minimally invasive surgery has been well studied. The risk of complications is similar to that of traditional open surgery. It is important to discuss your condition and surgical options with your colon and rectal surgeon. Together, you can weigh the risks and benefits of minimally invasive surgery versus traditional surgery. Minimally invasive surgery is not appropriate for all patients or conditions.

When is minimally invasive surgery an option?

Most traditional abdominal colon and rectal procedures can be performed via a minimally invasive approach. Multiple studies have shown when properly performed, minimally invasive surgery is an effective option for colon cancer. There is less research comparing minimally invasive surgery to traditional open surgery for rectal cancer. The general consensus is that minimally invasive surgery is suitable for rectal cancer in the hands of well-trained surgeons following accepted cancer surgery principles.

The following factors help determine if a minimally invasive procedure can be performed safely and effectively.

  • Prior surgical history.

  • Medical history.

  • Characteristics of the disease (such as inflammation, tumor size).

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