Rectal Cancer Operations (TME surgery)

Laparoscopic (keyhole) surgery

There are different types of bowel operation and it is possible to perform many of these with keyhole surgery. Long thin instruments are used to mobilise and free up the bowel using keyhole techniques and then a small incision is made at a suitable point to bring the bowel out. The bowel can usually be joined through this small incision. This is quite common practice for colon operations but perhaps less so for rectal operations. Your surgeon will talk to you in more detail about whether this is possible.

Right hemicolectomy

In this operation, the right part of the colon is removed due to problems in the first part of the large bowel or occasionally in the very last part of the small bowel. The two ends of the bowel are then sutured or stapled together.

Left hemicolectomy

During this part of the operation the left side of the bowel is removed and the two healthy ends are usually sutured back together. It is not normal practice to make a stoma for this operation but very rarely, it may become necessary and your surgeon will talk to you about this in more detail if it is required.

Anterior resection

This is an operation to remove all or part of the rectum. Part of the sigmoid colon and rectum are removed and then the healthy bowel above this area is joined to the remnants that are left inside the anus. How much of the rectum is removed depends on where the problem in the bowel is.

If it is towards the upper end of the rectum then there is a chance that the operation will be performed with rejoining the bowel and no need for a stoma. However, a stoma does become more likely with this operation as the join becomes closer and closer towards the bottom. In this circumstance, it is important to give the join every chance to heal without complication and a stoma is often used as a temporary measure to rest that part of the bowel. If this is the case, then a second smaller operation is performed to reverse the stoma and rejoin the bowel completely sometime after the initial operation. The surgeon will talk to you in a bit more detail about when this may be.

Total Mesorectal Excision

If it is a tumour in the middle or lower part of the rectum then it may well be that your surgeon recommends a TME (total mesorectal excision). This means taking out all of the rectum along with its blood supply, lymph nodes and envelope of fatty tissue (mesorectum) in order to try and give you the most effective chance of removing the tumour and all of the little glands associated with it. TME surgery can be performed by open surgery, laparoscopic surgery or transanal key-hole surgery (TaTME) depending on case selection. (not all cases are suitable for key hole surgery)


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