Laparoscopic Rectal Resection for Cancer
Manhattan Colorectal Surgeons
The rectum is continuous with the colon, and ends with the anus. Most cases
of rectal cancer are asymptomatic and diagnosed by a colonoscopy. Symptoms
may include rectal bleeding, pain, obstruction, and weight loss.
The cause is unknown, but most cases arise from growths in the colon’s
lining. Once diagnosed, treatments include laparoscopic rectal resection
which may include decreased postoperative pain and improved cosmesis.
Depending on the stage of the cancer, preoperative chemotherapy and radiation
and/or postoperative chemotherapy and radiation may be recommended.
To learn more about your treatment options, call Manhattan Surgical Associates at 646.798.4606.
Diagnosis & Treatment
The diagnosis for rectal cancer is often made using colonoscopy with biopsies
which are submitted to a pathologist for evaluation. Colonoscopies are
important in patients with a history of rectal cancer for surveillance
of the colon for development of tumor recurrence. These studies are often
utilized in the evaluation for evidence of metastatic disease and patients
may also have an endorectal ultrasound, where a slender ultrasound probe
is inserted through the anus into the rectum to evaluate the stage of
The treatment of rectal cancer varies based upon the local and distant
extent of tumor spread. It can include:
- Preoperative chemotherapy and radiation to shrink the tumor and decrease
the rate of local recurrence after surgery
- If there is no spread beyond the primary site, treatment is removal of the colon
- In selected patients with limited spread in the liver or lungs, removal
of the involved colon along with the tumor in the liver or lungs may be feasible
- If there is tumor spread beyond the primary tumor and it is not amenable
to removal, surgery may not be recommended. In this situation, chemotherapy
is often administered
Laparoscopic rectal resection for cancer is often performed to cure the
disease or treat symptoms. Using the laparoscope your surgeon will remove
the segment of colon with the tumor through several small incisions. In
selected patients, laparoscopic colon resection may result in decreased
pain, a shorter hospital stay, and improved cosmesis. It is performed
in the hospital and you will be admitted following the procedure.
Preparation for Laparoscopic Rectal Resection
The night prior to the procedure, you will be instructed to take nothing
to eat or drink after midnight. In addition, you will be prescribed a
bowel preparation. The preparation should be taken as instructed.
You will receive general anesthesia and monitored at all times by an anesthesiologist.
Small incisions are made in your abdomen and the rectum containing the
cancer will be identified using the laparoscope. Using specially designed
laparoscopic instruments, the segment of rectum with the cancer will be
removed, and the two ends reconnected. This procedure is called a laparoscopic
low anterior resection (LAR).
In some cases, when the tumor is very close to or involving the anal sphincters,
a laparoscopic abdominoperineal resection (APR) may be performed. A laparoscopic
APR involves removing the rectum and anus and creating a permanent colostomy.
There are many factors that contribute to the decision of the type of
resection performed for rectal cancer. Your surgeon will discuss the options
for resection with you at the time of your consultation.
Following a laparoscopic rectal resection, you will be admitted to the
hospital. You will receive pain medication and intravenous fluid. Once
bowel function returns and have no signs of fever or other complications
of the surgery, you will be discharged from the hospital. You will be
given a prescription for pain medication.
For more information,
contact our Manhattan colorectal surgeons online.