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Surgery is the most common treatment for early stage or “resectable” (removable) colorectal cancers. Your doctor will talk to you about which type of surgery is best for your cancer, depending on the extent of the tumor and where it is located. The three main types of surgery for colorectal cancer are 1) open, 2) laparoscopic, and 3) robotic.
Open surgery has been the typical method of removing tumors. Recent advancements in technology, however, have allowed new laparoscopic and robotic techniques. These are considered minimally invasive surgeries because doctors can make smaller incisions that can decrease recovery time.
Even though open surgery is still the most common type of surgery, a recent study of colorectal cancer patients showed a 35 percent decrease in open surgery between 2004 and 2012. Laparoscopic surgeries increased more than three times during those years (31 percent of surgeries), and robotic surgeries increased more than 41 times, although robotic surgeries are still the most rare, at 3.4 percent.
The decision to use minimally invasive surgery or open surgery should be discussed with your doctor and healthcare team. The best type of surgery for you is dependent on many things, including your health, your surgeon’s experience, and your cancer type. Open surgeries can take less time than minimally invasive surgeries, but minimally invasive surgeries usually have a faster recovery time.
Laparoscopic surgery (minimally invasive)
Laparoscopic surgery is a type of minimally invasive surgery. Instead of a big incision, the surgeon uses a few very small cuts (0.5-1 cm) to insert surgical instruments into the abdominal cavity. The main surgical instrument is a long, thin tube with a light and camera on the end. This is called a laparoscope. A larger incision, about 3.5 cm wide, is made to remove the tumor. The laparoscope transmits images from inside the body to video monitors in the operating room. Carbon dioxide (CO2) gas is used to inflate the abdomen and create space for the surgeons to operate. The gas is naturally absorbed or removed by the body. The surgical instruments function as an extension of the surgeon's hands. During the operation, the surgeon moves the instruments by watching the monitors. The surgeon will remove the segment of the colon or rectum that contains the tumor through the larger incision, along with the attached lymph nodes. The surgeon will check the rest of the intestines and liver to see if the cancer has spread.
Robotic surgery (minimally invasive)
The first robotic colorectal surgery was performed in 2001. Robotic surgery lets surgeons use miniaturized instruments, operated with a console. A 3D camera lets the surgeon complete an operation with enhanced precision, flexibility, and control. As in laparoscopic surgery, the surgeon uses several small abdominal incisions (0.5-1 cm) to insert the surgical instruments into the abdominal cavity, as well as a long and thin lighted tube with a camera on the end called a laparoscope. A larger incision, about 3-5 cm wide, is made to remove the tumor. The surgeon will remove the part of the colon or rectum with the tumor and attached lymph nodes. The surgeon will check other segments of the colon and nearby organs to see if the cancer has spread. Robotic operations provide high-quality images to the surgeon, but they take longer to perform and might be more expensive. Minimally invasive rectal cancer surgeries are often completed robotically.
Open surgery
During open surgery, the surgeon makes a large cut into the abdomen to remove the tumor and part of the healthy colon or rectum. The surgeon will remove the part of the colon or rectum with the tumor and the attached lymph nodes. The surgeon will check other segments of the colon and nearby organs to see if the cancer has spread. The large incisions affect recovery time.
