Dr. Iqbal discusses colorectal surgery and the treatments offered at the Dan L Duncan Comprehensive Cancer Center

A Guide to Advanced Colon and Rectal Surgeries


Surgery is the most common treatment for colorectal cancer. At the Dan L Duncan Comprehensive Cancer Center (DLDCCC) at Baylor St. Luke’s Medical Center, several types of surgery may be used to treat colorectal cancer, including stomach, colon, rectum, and small bowel procedures. Many surgeries for colon and rectal cancers involve removing tumors, the section where the tumor was found, surrounding normal tissue, and nearby lymph nodes.

"Colorectal surgery options have evolved quite a bit—not only in terms of techniques but in terms of indications for surgery."

Among the newest, most advanced procedures offered is the transanal total mesorectal excision.

What Is a Transanal Total Mesorectal Excision?

Transanal total mesorectal excision (taTME), often referred to as "bottom-up" surgery, is a new, ground-breaking procedure for patients with lower rectal cancer, and it is available at the Dan L Duncan Comprehensive Cancer Center. It is minimally invasive and utilizes leading-edge robotic technology so that patients have minimal pain and recovery time.

Instead of solely a dissection via the abdomen, as typically performed in a total mesorectal excision (TME), the taTME combines abdominal and transanal endoscopic approaches. With the endoscopic instruments inserted into the anus and laparoscopic equipment used to make the abdominal incision, this procedure allows for an easier and more precise dissection in the lower rectum.

Once the tumor is excised with the endoscopic equipment in the anus, the surgeon attaches the anus to the colon in a procedure called coloanal anastomosis.

Surgeons using this procedure can more easily visualize tumors in lower rectal cancers and safely remove them while avoiding a bigger incision on the skin.

What Are the Benefits of taTME?

Because taTME is less invasive, it helps patients recover with less pain, drug use, and time in the hospital. It also helps patients return to their normal lives much more quickly due to an earlier return of bowel function.

It is also a procedure that enables the surgeon to completely remove the tumor without the patient requiring a permanent ostomy. Often, a patient may need a temporary one, which is closed in three to six months, depending on the chemotherapy treatments following the surgery.

"Colorectal cancer treatment has evolved to allow surgery without causing abdominal scars," said Dr. Iqbal. "Even if major surgery is needed, newer surgical technologies make a permanent ostomy bag increasingly rare."

In addition to taTME, the DLDCCC offers several other advanced treatments for rectal cancer, as well as procedures for the colon and small intestines.

What Procedures Are Offered for Colon and Rectal Cancer?

In addition to taTME, surgeons at the DLDCCC perform the following procedures for the rectum:

  • Laparoscopic and Robotic Rectum Removal
  • Transanal Endoscopic Microsurgery (TEM)
  • Sphincter-Saving Reconstructive Rectum Removal
  • Laparoscopic Ileoanal J-Pouch Procedure (Proctocolectomy)

The center also offers comprehensive care for patients with colon cancer, with a wide range of advanced procedures, including:

  • Colon Resection (Colectomy)
  • Colostomy
  • Laparoscopic and Robotic Colon Removal
  • Recurrent and Re-operative Colon Surgery
  • Laparoscopic Colostomy
  • Laparoscopic Polyp Removal

Several procedures for the small bowel are offered as well, including:

  • Ileostomy
  • Small Bowel Resection
  • Laparoscopic/Robotic Small Bowel Removal
  • Laparoscopic/Robotic Small Bowel Removal
  • Presacral Tumor Removal

With the wide range of conditions treated and procedures performed, the DLDCCC is a center that offers its patients a multidisciplinary approach from teams of dedicated specialists.

"We are able to provide a seamless patient experience with good communication between physicians. We see the patients together in the same room and provide an outline of their care to them. Patients can make informed decisions about their care with all members of their treatment team in the same room," said Dr. Iqbal. "Our team works together to explore the best medical or surgical option to ensure the most successful outcome for the patient."

The Dan L Duncan Comprehensive Cancer Center offers personalized care for patients with cancer. The center’s specialists are passionate about serving their patients and the community through cancer screenings, prevention and education efforts, and genetic testing. Learn more about the center and schedule an appointment with their team of dedicated specialists.

Sources:
Onco’Zine | Common Myths about Colorectal Cancer Surgery Dispelled
Baylor Medicine | Colon and Rectal Surgery
Baylor Medicine | Transanal Total Mesorectal Excision (taTME)
Baylor College of Medicine | Colon and rectal cancers: Know your treatment options
Baylor College of Medicine | Do Patients Really Need Opioid Painkillers after Colorectal Surgery

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