Which patients are best candidates for minimally invasive rectal cancer surgery? What is video-assisted transanal surgery (TEVA)? How to choose the right type of treatment for Stage 1 rectal cancer? Leading Swiss abdominal cancer surgeon explains surgical treatment options for colorectal cancer and liver tumors.
Transcript of video
Rectal cancer minimally invasive surgery. 4. Dr. Anton Titov, MD. Rectal cancer diagnosis is fortunately made at earlier stages today. Early rectal cancer, precancerous lesions and benign adenomas are now being treated with minimally invasive surgical techniques. One such minimally invasive rectal cancer surgery is called transanal endoscopic microsurgery. You’re an expert in minimal invasive surgery in coloproctology. You extensively use minimally invasive surgery techiques for colon cancer and rectal cancer treatment. What are recent advances in minimal invasive surgery for rectal cancer? What minimally invasive methods do you use for other colorectal precancerous lesions? Dr. Christoph Maurer, MD. Yes, one of the most impressive advances in my hands is a new device for transanal dissections of early rectal cancer. We also use it to resect huge adenomas. You remember that in the 1980s, Dr. Gerhard Buess has created a large steel tube. It was inserted in the anus for rectal cancer surgery. And through this steel tube, Dr. Buess did his resections that were just difficult to accomplish. Because within this rigid tube it was difficult to get angles with your instruments. Also it was then difficult to get out the rectal tumors. What we do is we insert a single-incision laparoscopic surgery port within the anus. This is minimally invasive rectal cancer surgery operation. This is a flexible device in which you can insert your instruments. And you can angle with your instruments to resect rectal cancer tumor. That facilitates very much the dissection of rectal cancer tumor. You look in the video when you go into the anus with a camera. And you operate on rectal cancer while looking at the monitor. So you have a big advantage. And you can do this submucosal dissections. You can even complete rectal wall dissections of invasive rectal cancer. You can perform complete full-thickness rectal wall dissections without any problems. This is minimally invasive transanal surgery. This is really a big advantage. Also costs of rectal cancer surgery are markedly reduced with this device. Dr. Anton Titov, MD. So it is essentially an endoscopic surgery. You get the wider angle of view. And you essentially perform a laparoscopic resection of rectal cancer tumor. This minimally invasive technology is convenient for the surgeon. It also makes better results for the patient. Patients recover faster after surgical operation. Dr. Christoph Maurer, MD. Absolutely. We call it video assisted transanal surgery. It’s not really laparoscopy. Because we are not in the abdominal cavity. But we use also the same tools. So we call it video-assisted transanal surgery. Our technique is similar to laparoscopy. And it facilities, yes, minimally invasive resection of rectal cancer tumors. It’s really nice, I think. We like this minimally invasive transanal tumor surgery. Dr. Anton Titov, MD. And what kind of lesions are suitable for such endoscopic surgery? Dr. Christoph Maurer, MD. The large rectal adenomas, especially the flat, large adenomas. We even can remove the adenomas that have almost the whole circumference of the rectum. All these rectal adenomas are possible to remove with his technique. And we can resect early rectal cancers. That means T1 rectal tumors without evidence of lymph node metastasis. In these tumors we do a full-thickness rectal wall resection. We close the wound with a running suture. Dr. Anton Titov, MD. Well, this is an important advantage and it follows the minimal invasive and video-assisted surgical techniques in other surgery fields. Minimally invasive surgery is widely used in thoracic surgery, in abdominal surgery, and now in colorectal surgery. So that’s important for patients to know. Dr. Christoph Maurer, MD. Yes. Rectal cancer minimally invasive surgery. Video-assisted transanal surgery can be done for early stages of rectal cancer. Transanal Endoscopic Video-Assisted (TEVA) Excision of rectal cancer tumor is the best surgery method. Your surgeon must have a lot of experience with Video-assisted transanal surgery to perform rectal cancer resection without complications. Why transanal surgery is the best minimally invasive rectal cancer treatment? Transanal Endoscopic Microsurgery (TEMS) is another method to treat rectal cancer.