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Minimally Invasive Colorectal Resection to Treat Colon Cancer

Richard L. Whelan, MD, Chief of the Division of Colorectal Surgery in the Department of Surgery at St. Luke's and Roosevelt Hospitals and the Director of Surgical Oncology for the St. Luke's-Roosevelt Hospital Center Sites of the Continuum Cancer Centers of New York, performed the surgery you will be viewing, which is a minimally invasive colorectal resection to treat colon cancer.

Viewing this Webcast should make it easier for you, the patient, to understand what constitutes a laparoscopic (also called minimally invasive) colorectal resection.  In addition, a brief discussion is included about how colon cancer is diagnosed, the tests that are typically performed once the diagnosis has been made, and the surgical treatment options.  What to expect after surgery is also covered in this presentation. 

During a colon resection, also known as a colectomy, the diseased part of the large intestine is surgically removed and the remaining healthy ends of the colon are reattached. The procedure you are about to watch was performed to remove a cancerous tumor, however, people with numerous other gastrointestinal disorders including large benign polyps, Crohn's disease, Ulcerative Colitis and diverticulitis may also require removal of a part of their colon.

The standard surgical method, until the 1990's, was to make a 6 to 10 inch incision in the abdomen, called an open approach.  The newer alternative, a laparoscopic operation, is carried out by inflating the abdomen with carbon dioxide (CO2) gas to lift the abdominal wall (where the belly button is) off of the intestines and other organs in the abdominal cavity to create a space (like a dome or tent) within which the surgeon can work.  Then, 3 to 5 small incisions are made at various places on the abdominal wall (each 1/4 to 1/3 inch in size) through which hollow tubes called "ports" are inserted. Each port has a valve which prevents the CO2 gas from leaking out.

 A camera is inserted into the abdomen through one of the ports and provides a magnified view of the abdomen. The operation is performed by manipulating long, thin surgical instruments which are inserted through the other ports.  Towards the end of the operation an incision between 1 ½ and 3 inches is made in order to remove the resected piece of colon and to reattach the two remaining ends. 

The proven advantages of the minimally invasive approach are:

• less pain after surgery
• a shorter hospital stay
• a quicker return to a normal diet
• a much smaller abdominal wound

The laparoscopic approach has been proven to be safe and effective for the removal of cancers in numerous large randomized trials that compared the open and laparoscopic methods.  While not appropriate for everyone, between 85 and 90% of patients are candidates for minimally invasive colon resection.

Dr. Whelan has been performing laparoscopic surgery for colorectal cancer, diverticulitis, benign colon polyps, and inflammatory bowel disease for over 18 years.  He has published more than 120 peer-reviewed articles and book chapters on the topic.  He has also lectured widely in the U.S. and abroad and sits on the editorial boards of the journals Surgical Innovations, Surgical Endoscopy and Surgery. Dr. Whelan and his research team have also carried out numerous clinical studies in an effort to better understand the impact of surgery on the body's physiology and ability to recover.  Dr. Whelan is also carrying out studies in which interested patients are receiving anti-cancer drugs during the month before and after surgery in an effort to decrease cancer recurrence.     

To schedule an appointment with Dr. Whelan, please call
(212) 523-8172.

Participants

Featuring:

Richard Whelan

Richard Whelan, MD

Chief of the Division of Colorectal Surgery in the Department of Surgery at St. Luke’s