Keyhole surgery for colorectal cancer: Insights and considerations

In his latest online article, Mr Alistair Slesser gives us his insight into keyhole surgery for colorectal cancer. He talks about how the surgery is performed, how effective keyhole surgery is, if some patients are more suitable to traditional surgery, the chances of being cured after undergoing keyhole surgery and the associated risks.

How is keyhole surgery for colorectal cancer performed?

Minimally invasive surgery is performed using small instruments which are inserted into the abdominal cavity using small 5mm or 10mm ports which only leave very small scars on the abdominal wall. An assistant uses a high-definition magnified camera inserted through a small port to provide a magnified view of the structures within the abdomen providing a much better view for the operating surgeon than is possible with open surgery. At the end of the surgery a small extraction wound is fashioned and the affected piece of bowel is removed through the small incision.

How effective is keyhole surgery for colorectal cancer treatment?

Keyhole surgery has been demonstrated to be equivalent to open surgery in terms of cancer outcomes. It is now considered the gold standard for performing colorectal cancer surgery. The main benefits of keyhole surgery are related to the better post-operative recovery that is associated with this approach compared to an open approach. Approximately ninety per cent of my colorectal cancer patients will have a completely minimally invasive operation for their cancer surgery.

Would some patients be more suitable to traditional, open surgery?

The aim of colorectal cancer surgery is to achieve a complete resection of the tumour. There are some patients who have had previous surgery or where the tumour is advanced and, in these cases, it is better to perform an open approach. I am experienced in open surgery and thus I will usually advise the patient on the best approach depending on patient and tumour factors.

What are the chances of being cured of colorectal cancer after undergoing keyhole surgery?

The chances of long-term survival after undergoing keyhole surgery are high. There is no difference in long term survival between an open or a key hole approach. The key to long-term survival is detecting the cancer at an early stage. I provide surveillance for all patients with concerning symptoms and it is important to see a colorectal surgeon early if you have any concerning symptoms such as bleeding or a change in bowel habit.

What are the associated risks, and what does recovery involve? Would another surgery be necessary?

Keyhole surgery for colorectal cancer surgery is major surgery. As such it does carry risks related to injury to intra-abdominal structures, bleeding and risks of medical complications such as chest infection. The most important risk is a leak of the join (anastomosis) which is approximately between a one in twenty risk. The mortality rate is approximately 1-3/100 in the UK. Sometimes if a patient suffers a complication such as a leak of the join or bleeding, they do need to return to theatre albeit rare.

Mr Alistair Slesser is a distinguished consultant colorectal and general surgeon with over 20 years of experience. You can schedule an appointment with Mr Slesser on his Top Doctors profile.