Laparoscopic colorectal surgery for bowel cancer

In the UK, colon cancer is still the most common cause of non-smoking-related cancer deaths.

Approximately 40,000 new colon cancer cases are diagnosed each year in England and Wales. According to CRUK, one in 14 men and one in 19 women will develop colorectal cancer within their lifetime.

Surgery to remove the segment of colon or rectum containing the cancer along with its blood vessels and lymph glands is the only way to potentially cure colorectal cancer.

The earlier the cancer is detected, the more likely people are to survive. Over 90% of patients diagnosed with the earliest stage of colon cancer survive for five years or more after surgery.

Open surgery for colorectal cancer

Open surgery, in which an incision is made in the abdominal wall so that the colorectal surgeon can access the bowel directly. This is an effective technique in terms of curing colorectal cancer. However, as the abdominal muscles as well as the bowel are cut. The level of pain experienced in the few days after is considerable.

Patients are usually given stronger painkillers and are much less mobile in the first couple of days after open surgery compared with modern keyhole techniques.

This leads to prolonged recovery times and a longer stay in hospital, which can be frustrating for patients and relatives. It also results in a slower return to normal activities and work.

Larger incisions in open surgery can also lead to abdominal wall hernias in the future which can limit activity and require further surgery.

Laparoscopic surgery for colorectal cancer

Several small incisions (ports) no more than 1 cm in length are made on the abdomen. The laparoscope, which transmits images from inside the body to a high-resolution screen in the operating theatre, is put in place through one of the ports.

The others are used to introduce the surgical instruments needed to cut away the part of the large bowel that contains the cancerous tumour.

One of the incisions may need to be enlarged slightly to remove the tumour and the bowel tissue. This depends on the size of the tumour but is usually no bigger than 5 cm. A typical open surgery wound is around 20 to 30cm long.

The cut ends of the healthy bowel are then re-joined. The whole operation takes about three-quarters of an hour longer than open surgery depending on the complexity of the case.

Recovering from laparoscopic surgery

Many hospitals that offer laparoscopic colorectal surgery have an enhanced recovery programme. This will get you mobile, eating and drinking within 24 hours, and then home a few days quicker than with traditional open surgery.

People who have keyhole surgery for bowel cancer report far less pain in the few days afterwards.

Good follow up is then essential to look out for any signs that your cancer has recurred. You will have regular check-ups every few months for the first year, and then less frequently thereafter.