If you're struggling to find what you need, call our Support line on Monday to Friday, 9am-8pm. Surgery to remove the Anal 3 Through Keyhole is the most common treatment for rectal cancer. Surgery may also be done to treat a blocked bowel or cancer that has spread to other parts of the body.
Anal 3 Through Keyhole most common operation to remove cancer from the rectum is a total mesorectal excision TME. The surgeon removes part or all of the rectum, depending on the size of the cancer and where it is.
A TME may be done using laparoscopic surgery keyhole surgery. The surgeon makes several cuts in the tummy and uses special tools to see inside the rectum and remove the cancer.
After bowel surgery, some people have an opening on the tummy wall to pass poo stools through. This is called a stoma. A bag over the stoma collects poo. A stoma may be temporary to let the bowel rest after surgery. But it can sometimes be permanent. Your surgeon will talk to you about your operation and if you need a stoma. You may have radiotherapy or chemoradiation before surgery.
This can make it easier to remove the cancer. It also lowers the risk of the cancer coming back in the rectum or in the tissues close to it. There are different techniques and types of operation that can be used. The type your surgeon recommends will depend on the stage of the cancer, where it is in the rectum and your general health.
After the operation, all the tissue that the surgeon has removed will be sent to a pathologist. They will check the tissue carefully for any cancer cells close to the cut ends the margins.
If they find cancer cells in the margins, it is possible that not all of the cancer was removed during the operation. This is not common, but if it happens you may be offered a second operation or radiotherapy. Very small, stage 1 rectal cancers can sometimes be removed using a local resection. This is a small operation to remove the cancer and some healthy tissue surrounding it.
The surgeon inserts an endoscope into the
Anal 3 Through Keyhole to remove the cancer.
An endoscope is a long, flexible tube with a tiny camera at the end. This surgery is called transanal endoscopic micro surgery TEMS. If the cancer is very low in the rectum and close to the anus, the surgeon may not need an endoscope. They may be able to remove the cancer by passing surgical instruments up the anus. This is called a transanal rectal resection. This is the most commonly used operation to remove rectal cancer. The surgeon removes the part of the rectum that contains cancer, as well as some healthy bowel on either side.
They also remove the fatty tissue mesorectum around the rectum, which contains blood vessels and lymph nodes. Removing the mesorectum reduces the risk of any cancer being left behind. In the diagram below, the black dotted line shows an example of the tissue that may "Anal 3 Through Keyhole" removed during a TME operation. There are different types of TME operation.
The large bowel and mesorectum View a large version. Read a description of this image. Open surgery means the surgeon makes one large cut incision. Afterwards, you have a wound that goes down in a line
Anal 3 Through Keyhole just below your breastbone sternum to just below the level of your tummy button navel.
Some people have a wound that goes across their tummy abdomen instead. In laparoscopic surgery, the surgeon makes four or five cuts in the tummy rather than one big cut.
They pass a laparoscope into the tummy through one of the Anal 3 Through Keyhole. A laparoscope is a thin tube containing a light and camera.
They then pass specially designed surgical tools through the other cuts to remove the cancer. A surgeon performing laparoscopic surgery View a large version. Laparoscopic surgery is sometimes used when the cancer is small. It uses a specialised technique and is not available in all hospitals. If this surgery is the best type for you to have, you may be referred to another hospital to have it done.
Recovery from laparoscopic surgery is usually quicker than recovery from open surgery. Your surgeon will talk to you about which type of surgery is likely to be best in your situation. During the operation to remove the cancer, an opening is sometimes made through the tummy abdominal wall.
This lets the bowel connect to the surface of the tummy. It is called a stoma. It is round or oval, and it looks pink and moist. Poo stools will no longer pass out of the rectum and anus in the usual way. Instead it will pass out of the stoma, into a disposable bag that is worn over the stoma.
The stoma is made from an opening in part of the bowel. If the stoma is made from an opening in the colon, it is called a colostomy. If it is made from an opening in the small bowel ileumit is called "Anal 3 Through Keyhole" ileostomy.
Stomas can be temporary or permanent. A surgeon may make a temporary stoma to allow the bowel to heal after surgery. To make a loop stoma, the surgeon pulls a small loop of bowel out through a cut in the tummy.
They then make an opening in the loop of bowel and stitch the loop to the skin. This forms the stoma. To make an end stoma, the surgeon removes the section of bowel that contains cancer. This leaves two open ends of bowel.
The surgeon brings the active end out to the surface of the tummy and stitches it into place. This forms a stoma. The inactive end of bowel, which leads to the rectum back passageis stitched closed and
Anal 3 Through Keyhole inside the tummy. If you have a temporary stoma, you will usually have a second Anal 3 Through Keyhole operation a few months later to close the stoma and rejoin the bowel.
This operation is called a stoma reversal. If the cancer is very low in your rectum and close to the anus, you are more likely to need a permanent stoma. Your surgeon
Anal 3 Through Keyhole tell you whether you are likely to have a stoma after your operation, and whether it will be temporary or permanent.
If you need to have a stoma, you will be referred to a stoma nurse who specialises in stoma care. The type your surgeon recommends will depend on where the cancer is in your rectum, the size of the tumour and how far it is from the anus.
An anterior resection is usually used for cancers in the upper and middle parts of the rectum close to the colon. After the piece of bowel that contains the cancer is removed, the surgeon rejoins the two open ends of bowel.
The diagrams opposite show the part of the bowel that is removed, and how the two ends are joined together. Some people may have a temporary stoma usually an ileostomy after this operation. A stoma reversal can usually be done a few months later. Anterior resection — area to be removed View a large version. Anterior resection - bowel has been rejoined View a large version. This operation may be used for tumours low in Anal 3 Through Keyhole rectum.
The surgeon removes all of the rectum and attaches the colon to the anus. Sometimes, the surgeon makes a pouch called a J pouch from part of the colon, before joining it to the anus. The pouch acts like a new rectum and stores poo stools until it is convenient to pass them. The diagram below shows a J pouch. You may have a temporary stoma usually an ileostomy after this operation. This allows the bowel to heal. J pouch surgery View a large version.
This operation is usually used for cancers that are very low in the rectum near to the anus. In order to remove all of the cancer, the surgeon needs to remove the rectum and anus. You will have a permanent stoma usually a colostomy after this operation. As well as the wound on your tummy, you will have a "Anal 3 Through Keyhole" on your bottom where the anus has been closed.
Abdomino-perineal resection - area to be removed View a large version. Permanent stoma formed after abdomino-perineal resection View a large version. Colostomy bag outside the body View a large version.
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