There are several factors that determine whether or not someone needs invasive surgery for colorectal cancer. In this video, Dr. Mark Gimbel explains the different circumstances that warrant surgery.
Mark Gimble, MD: So after reviewing all the tests, if somebody is deemed a surgical candidate that means they can undergo surgery then we take him to the operating room. I have to plan my surgery based on where the cancer is and if I can do it either minimally invasive or I have to do it open. One of the things that dictates how I am going to approach the cancer is, the size of the cancer and if there lymph nodes are involved. Now the lymph nodes are actually within the mesentery of the colon. If you think of the colon as a curtain rod, all the blood vessels and lymph nodes are in that curtain that hangs down from the curtain rod. So I need to make sure I take enough normal colon around the actual cancer and then I have to take a wide enough resection of the blood vessels and lymph nodes to make sure I accurately stage it. If the cancer is too big, most of the time I have to do the surgery with an open incision and that’s called maximally invasive or open surgery. If the cancer is smaller or there are no bulky or big lymph nodes then a lot of times, I can do it minimally invasive and minimally invasive surgery means either laparoscopic or robotic. Laparoscopic is essentially making small incisions using cameras and instruments to dissect out the colon with the cancer and then you have to make a larger incision to remove the actual specimen and robotic surgery is quite similar, but you are using the robot to able to move the instruments a little bit finer and be able to do a little bit more finer within the actually body, but it’s still essentially is a minimally invasive or a take a laparoscopic surgery.
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