Did you know that colorectal cancer is the second-deadliest form of cancer in the country, but it often presents no symptoms in patients? In fact, about 60% of all colorectal cancer patients are asymptomatic when they’re diagnosed. And in some cases, due to lack of awareness, patients end up with a later stage of cancer, requiring them to undergo surgery to remove those cancerous polyps.
Luckily, technological advances in robotically assisted surgeries have grown over the past few decades, opening the door for more patients to receive minimally invasive surgery to treat their cancer.
But what’s the difference between minimally invasive surgery and traditional colorectal surgery? And are there any actual benefits to the former? We’ll cover that and more here.
First, let’s discuss the differences between open and minimally invasive surgery.
Open Surgery vs. Minimally Invasive Surgery
Open Surgery
Traditional colorectal surgery comes in several forms but is, in some cases, prefaced by either chemotherapy or radiation therapy, which can help shrink the tumors before they are removed. Your doctor would walk you through the protocol’s specifics if they felt it was necessary for your treatment plan.
For patients with stage 0 or stage 1 colorectal cancer, a doctor will perform a colonoscopy (if it has not already been done before).
A colonoscopy doesn’t require any incisions and is well known as the gold standard for detecting, preventing, and removing cancerous or precancerous polyps. The doctor can access the colon or rectum with a colonoscope and an attached tool to help them remove polyps or abnormal cells. If those cells or polyps cannot be removed, a more advanced surgery is recommended.
For later stages of colorectal cancer, a patient may be required to get a colectomy, polypectomy, colon resection, or colostomy to treat the cancer. Each treatment option is used in different situations but can require a long open incision along the abdomen to help the surgeon access the necessary area. Due to the nature of these incisions, patients may need to stay in the hospital for a week or more and often face a longer recovery time. However, some surgeries can also be done using minimally invasive techniques.
Minimally Invasive Surgery
There are two types of minimally invasive procedures: laparoscopic surgery and robotically assisted surgery. Each is performed similarly but uses different instruments.
Approximately four or five small incisions are made to the abdomen at the start of the procedure. Afterward, your surgeon will insert a laparoscope or Da Vinci® camera – a very thin tube with a tiny camera attached – that projects its video imaging onto a larger screen for your doctor to use as a guide while they navigate the abdomen. Other necessary instruments are then inserted into the remaining incisions to give your doctor the tools they need to perform the surgery. While inside, they can identify and remove all (or most) of the cancerous or precancerous polyps they find.
The Benefits of Minimally Invasive Surgery
While most pre-operative protocols are the same regardless of which surgery is performed, the recovery is not. We spoke to Dr. Godshalk Ruggles, colorectal cancer expert at Capital Health Cancer Center, who outlined some of the benefits patients can expect from having a minimally invasive procedure done as opposed to open surgery:  Â
- Less recovery time: While the recovery period for open surgery on the abdomen can take upwards of two weeks for some, that’s not the case for minimally invasive procedures. “The average length of stay here is two days,” said Dr. Godshalk Ruggles, “so patients are getting home pretty quickly, which they’re always surprised to hear.”
- Faster return to full bowel function: While open surgery requires your body to take more time to heal both internally and externally, ultimately requiring medical supervision while you recover, minimally invasive procedures allow your bowel to function much sooner following the procedure.
- Less post-operative pain: Patients undergoing open surgery generally require pain medications and lots of rest before returning to normal daily activities. However, for minimally invasive procedures, the change is significant. “Most of the time, I’ll have patients who come back and say, ‘It was amazing; I had no pain,’ or ‘I hardly felt like I had surgery at all,'” Dr. Ruggles explains. “They’re going out to dinner with friends and they’re back to their normal life and normal routine.”
Robotically Assisted Surgery
Although laparoscopic surgeries led the way for minimally invasive procedures, robotically assisted surgeries done with the Da Vinci® Surgical System are becoming more prevalent for surgical oncologists nationwide. Most colorectal surgeries are not being done robotically though, so this is a unique expertise that Dr. Godshalk Ruggles has the specialized training to provide. Dr. Godshalk Ruggles spoke to us about their differences and why she believes robotically assisted procedures are less complex to perform.
“There’s a massive difference in terms of the dexterity and the ease of manipulation you have when you’re doing robotic surgery,” Dr. Ruggles says. “[With laparoscopic surgery] it’s much less nuanced, much harder to be precise.”
She also highlighted how these surgeries can be less taxing for your doctor when robotic tools aid them. “You know, people don’t often think about how strenuous it is to operate on someone – but when I’m doing an open surgery, I will feel that in my body for the next week. Whereas, when you’re sitting and it’s very fine motor movements to control the robot arm, it makes a huge difference.”
Get Screened for Colorectal Cancer
Did you know that about 95% of patients diagnosed with colon cancer have no genetic correlation or family history? It’s a common misconception but one that can give people a false sense of security if there is no family history of colorectal cancers, even if they may be at a higher risk due to other behaviors or factors.
Colonoscopies are the gold standard for detecting, preventing, and treating colon cancer. As of 2022, all adults 45 and older are recommended to have a colonoscopy to screen for colorectal cancer. Make an appointment with your doctor today, or schedule an appointment to see Dr. Godshalk Ruggles or one of her team members at Capital Health.