Colon cancer is a type of cancer that affects the large intestine. One of the main treatment options for colon cancer is surgery. In this video, we will cover key things you need to know about the different types of surgery available for colon cancer. It's important to understand that there are various types of surgery for colon cancer, and the most suitable operation for you will depend on several factors. These include the location of your cancer, its type and size, and whether or not it has spread to other parts of your body. Because this is such an individual matter, the team caring for you, including your surgeon, should discuss each of the options with you. This will help you make an informed decision.

There are many different types of surgery for colon cancer. In the next few sections of the video, I'll introduce you to some of the more common ones and give you an overview of what they are called and what they entail.

The first surgery we'll discuss is a local resection, which involves removing a small part of your bowel lining. Typically, this surgery is for small, early-stage cancers. In this type of surgery, your surgeon removes the cancer from the bowel lining along with a border of healthy tissue, known as the margin. Think of it like this: imagine the tumor is in one part of the bowel. The surgeon will want to cut that tumor out and also take out some of the normal-looking surrounding tissue to ensure that they've removed all of the tumor and that small bits of it haven't spread to the surrounding tissue. In this operation, the surgeon uses a flexible tube called a colonoscope to perform the procedure. The tumor, along with the surrounding tissue, will then be sent off to the lab to be examined under a microscope.

Next, we have surgery to remove all or part of your bowel, known as a colectomy. This is a much larger operation than a local resection. How much of the bowel your surgeon removes depends on the exact position and size of the cancer. These operations have different names depending on where the cancer is located. Surgery to remove just part of the colon is called a hemicolectomy or partial colectomy. On the other hand, surgery to remove the entire large bowel is called a total colectomy. After your surgeon removes your cancer, they will want to join the ends of the bowel back together. Sometimes, to give the bowel time to heal, the surgeon will create an opening on your abdomen or tummy, which is called a stoma.

There are two main types of stomas: a colostomy and an ileostomy. These might sound complicated, but don't worry, I'll explain each of them. A colostomy involves creating an opening in the large bowel that is brought out onto the surface of the tummy. Your stool will no longer pass through your body via the back passage; instead, it will pass out through the stoma and be collected in a bag that sticks to the skin over the stoma. An ileostomy, on the other hand, involves creating an opening in the small bowel, called the ileum, onto the surface of your tummy. With an ileostomy, your stool comes out through the stoma and is collected in a bag, but it is usually liquid rather than solid.

A stoma is usually temporary, and you typically have another operation to repair the stoma after a few months, known as a stoma reversal. However, if a significant portion of your bowel is removed, the surgeon may need to create a permanent stoma. Most people do not need a permanent stoma. Sometimes, the surgeon cannot determine whether a permanent stoma is necessary until they are performing the operation, as they may not know the size or extent of the cancer. Your surgeon should explain this to you and discuss the likelihood of needing a permanent stoma before the operation begins. While they cannot make any guarantees, they can give you a good sense of what to expect.

In terms of living with a stoma and caring for it, this is a different topic entirely. I've included some helpful resources in the description box of this video from the NHS and various charities focused on stoma care. These organizations have lots of useful resources on their websites, and I encourage you to take a look at them in your own time. Additionally, there is a fantastic individual named Mason, known as Mr. Crohn's Colitis, who is very active on YouTube. I encourage you to check out his channel, as he has some very helpful videos on living with a stoma. Also, ask your healthcare team about the specialist stoma nurse team at your hospital. These experts in stoma management and care can provide you with valuable tips and support as you transition through this important journey.

Sometimes, bowel cancer can cause a blockage in the bowel, known as a bowel obstruction. If this happens, you'll need an operation immediately, as the bowel could perforate if it is blocked and stool has no way to exit. In such cases, the surgeon may insert a tube called a stent into the bowel to hold it open, allowing it to function properly again. Alternatively, they may remove the tumor completely.

There are two main methods for performing bowel cancer surgery: open surgery and keyhole (laparoscopic) surgery. Open surgery involves making one long cut down your tummy to remove the cancer. In contrast, keyhole surgery involves making several small cuts in your abdomen and using small cameras and instruments to remove the tumor. Keyhole surgery generally allows for quicker recovery and smaller scars. Your surgeon might offer you keyhole surgery if it is appropriate for your situation, but some people are not candidates for this type of surgery. It's important to discuss this with your surgeon before the operation.

Sometimes, the surgeon may need to switch from keyhole to open surgery during the operation. Your surgeon will discuss this possibility with you beforehand and explain the risks and benefits of the operation, obtaining your consent before proceeding. If you are unclear on any of the risks, don't hesitate to ask for clarification.

Some surgeons use a robotic system to assist with keyhole surgery. This machine has four arms: one holds the camera, and the others hold the surgical instruments. The surgeon controls the machine's arms to remove the cancer. Robotic surgery is still relatively new, and not all hospitals have this technology. However, it is thought to reduce the need to switch to open surgery and potentially reduce complications during and after surgery. Ask your surgeon if robotic surgery is an option for you.

For more information on bowel cancer treatment, stomas, chemotherapy, and other helpful resources, please check out the links in the description box of this video. Feel free to leave a comment if you have any general questions or other comments, as I would love to hear from you. Sharing your experiences with bowel cancer or surgery can be incredibly valuable and help others going through a similar journey.

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