The treatment of rectal cancer is often a combination of chemotherapy, radiation therapy and surgery due to the unique anatomy in the pelvis. The rectum is close by other structures like the bladder and the nerves that control your ability to use the bathroom as well as those that affect your sexual health.
Your surgeon may recommend one of the following:
Traditional or “Open” Surgery
Traditional surgery is often called open surgery. It usually involves a single incision (cut) that is large enough so that a surgeon can operate using their hands.
Why your surgeon would recommend open surgery:
- If you have had other abdominal surgeries and there is a concern for scar tissue.
- If more than one organ is involved and needs to be managed.
- If the cancer has spread (metastasized) beyond the rectum to other organs,
open surgery may be the most efficient way to remove tumors from the rectum and other organs at the same time.
Minimally Invasive Surgery
Surgeons may be able to use minimally invasive approaches. These include laparoscopic and robotic-assisted surgery.
Laparoscopy
During a laparoscopy, your surgeon uses a thin, lighted tube with a video camera at its tip. This tool is called a laparoscope. Multiple small holes are made in the abdominal wall to insert a camera and instruments into the abdomen. Once the goals of the operation are accomplished, a small incision is made to remove the tissue of concern.Robotic-assisted surgery
In robotic-assisted surgery, a camera and instruments are inserted through keyhole-size cuts in the abdominal wall, just like laparoscopy. Then, robotic arms are attached to the instruments and your surgeon sits at a computer and uses controls to move the robotic arms. A high-definition visual system helps your surgeon see more clearly by magnifying the operation.
Why your surgeon would recommend one of these minimally invasive procedures:
- Surgeons can use smaller incisions than in open surgery.
- These techniques can help minimize damage to nearby organs and tissues.
- A lower risk of infection and less blood loss.
- Patients often recover faster.
Transanal Procedures
Transanal endoscopic microsurgery (TEM)
TEM involves removing early-stage rectal cancer using a scope that’s inserted into the anus. It’s a less invasive procedure than open or minimally invasive abdominal surgery.
Why your surgeon would recommend transanal endoscopic microsurgery (TEM):
- It minimizes treatment-related complications and reduces recovery time.
- It can be optimal for older patients with medical conditions that would make longer and more complex operations difficult.
- It spares the nearby nerves associated with the ability to use the bathroom normally as well as with sexual health.
- People who have TEM don't need a colostomy, which is an operation that creates an opening for the colon through the abdomen and may be temporary or permanent.
- You can go home soon after the procedure.
Transanal minimally invasive surgery (TAMIS)
Stony Brook's colorectal surgeons have performed a number of transanal minimally invasive surgical (TAMIS) procedures. These facilitate the resection of large rectal tumors in select patients who would otherwise require a radical operation. TAMIS is a specialized minimally invasive approach to removing benign polyps and some cancerous tumors within the rectum and lower sigmoid colon (the end portion of the large intestine before reaching the rectum).
Why your surgeon would recommend transanal
- TAMIS is performed entirely through the body’s natural opening, requiring no skin incisions to gain access to a polyp or tumor. This scar-free recovery provides a quick return to normal bowel function.
- Your surgeon will precisely remove the diseased tissue, leaving the rest of the natural bowel lumen intact to function normally.
- The procedure may only require an overnight stay in the hospital or can be performed as an outpatient procedure.
Return to Overview Surgery webpage.