Minimally Invasive Cancer Surgery

Facing cancer is challenging enough without having to contemplate all that is involved in recovering from a major open invasive surgery.  And while in some cases cancer surgery must involve major open incisions and large wounds, in this day and age most cancers can be treated with minimally invasive surgery techniques.

Dr. Sasse has performed a great number of minimally invasive cancer procedures for adrenal tumors, splenic tumors, tumors of the lymph nodes, liver tumors, gastric tumors and intestinal tumors.  All types of intra-abdominal tumors lend themselves to a minimally invasive approach in skilled, trained hands.  Of course, more common than all of the above are colorectal tumors, which are removed surgically with a minimally invasive approach in Dr. Sasse’s hands in nearly all cases.

The advantages of a minimally invasive approach to cancer surgery are numerous:

First and foremost, in the right expert hands, it is the best surgery to treat and cure the cancer.  There is no corner cutting or compromise on the cancer curing effect on minimally invasive surgery.  Many years ago when laparoscopic surgery was first being developed, some worried that the technique of laparoscopy might lead to reduced cures of cancer, particularly colorectal cancer.  Studies done at my Alma Mater, the Lahey Clinic, among other centers, demonstrated that laparoscopic cancer resection, performed by skilled minimally invasive surgeons, such as Dr. Sasse, resulted in at least as good a cure for colorectal cancer.  This meant at least as good a harvest of a high number of lymph nodes and obtaining at least as wide margins around the tumor.  Furthermore the “no touch technique” that was honored by early cancer surgical pioneers is followed meticulously in laparoscopic minimally invasive surgery, which also by the way is dramatically less traumatic.

So minimally invasive surgery is at least as good a cancer cure, but what else makes it better for cancer surgery?  The real benefit and superiority lies in the reduced invasiveness, the reduced complications, and the reduced recovery time, pain and delay in returning to a full recovery.  All of these issues matter a great deal.  Keep in mind that one of the unsung benefits of minimally invasive cancer surgery is that is has allowed so many people to recover much more quickly so they can fight the cancer sooner and more effectively whether they are pursuing chemotherapy, medical therapy, radiation therapy or other means.  The reduced “down time” after minimally invasive surgery allows the person battling cancer to get on with the battle sooner and to do so from a stronger stand point of physiologic health.

“First do no harm” was one of the guiding principles of Hippocrates, the Greek Father of Medicine.  Surgery by necessity involves some degree of invasiveness and some risks of complications, some pain and some recovery time during which a person is not at full capacity.  Minimally invasive surgery seeks to minimize all of those effects and does so quite successfully.  Today, thousands of studies have demonstrated the reduced complication risks across the board in minimally invasive surgery for minimally invasive abdominal cancers, colorectal cancer, thoracic cancer and many other types of cancer, minimally invasive surgeons have succeeded in removing the tumors while markedly diminishing the risks of wound infections, wound complications, hernias, heart complications, breathing complications and other types of adverse events.  Additionally, the studies demonstrate that minimally invasive surgery reduces the risk of bleeding and results in fewer blood transfusions.  It also results in far less pain and thus less use of narcotics and other medications, which of course have their own side effects.  So in summary, minimally invasive surgery today, in the skilled hands of trained minimally invasive surgeons results in highly successful cancer therapy and cancer cure while minimizing the risks, complications, down time and pain.  It allows you to return to health sooner, to your activity sooner to battling to cancer sooner and to getting on with life sooner.

MINIMALLY INVASIVE COLORECTAL SURGERY

The diagnosis of colorectal cancer understandably creates a great deal of anxiety and worry for anyone who‘s loved one is facing a disease such as this.  The revolution of minimally invasive surgery decreases that worry a great deal.  Laparoscopic or minimally invasive colorectal cancer surgery has markedly diminished the risks, complications, pain and recovery time associated with undergoing cancer surgery for the colon and rectum.  It also has provided a highly successful technique in which trained skilled hands in laparoscopic colorectal cancer surgery delivers a cure of the disease in a high percentage of cases.

Colorectal cancers historically have been treated with an open laparotomy surgical procedure.  Keep in mind that a very high percentage, nearly over 90%, of the global benefit that modern medicine can bring to the disease of colorectal cancer comes from removing the tumor and its regional lymph nodes through surgery.  While chemotherapy and radiation have made great strides, they still contribute a relatively small fraction of the overall benefit when measured in terms of months or years of life gained.

Today minimally invasive colorectal cancer surgery accomplishes the mission of removing the tumor and the surrounding lymph nodes and providing a cure.

Colorectal cancer is only cured with resectional surgery while there are a few scattered reports of small rectal carcinomas shrinking and even disappearing with chemotherapy and radiation therapy prior to undergoing surgical resection, it is not considered a accepted treatment if one is seeking to cure the cancer it has been felt that the chances of the dormant tumor cells re-growing and spreading is far too high.

So surgery is the key to treating and curing colorectal cancer and minimally invasive surgery is the most effective method with the least invasiveness, the least complications and the least pain.  Let’s discuss a little bit why that is the case.

To begin with, a traditional or open conventional surgery involved making a larger abdominal incision.  Right there begins the invasiveness that leads to pain and prolonged recovery time.  The incision or wound itself is the main culprit in causing post-operative pain, which in turn leads to treatment of the pain with narcotic and other classes of drugs.  These drugs in turn have their own side effects, which in some cases can be quite serious so minimizing the incision, in fact getting rid of it all together and instead performing the procedure with markedly smaller laparoscopy incisions results in dramatically less pain and dramatically less use of narcotic analgesic medications.

 

Perhaps the most important of all, the large open incision leads to more down time after surgery.  This results from a number of effects, both direct and indirect.  Indirect effects include the strain on the heart and lungs as our bodies cope to heal up after a more intrusive surgical procedure.  The direct effects of the pain cause us to breathe more shallowly, to walk less and take more time to restore the natural physiologic functions.  This means more time in the hospital.  It also translates into many more weeks before one can return to work, before one can return to cancer treatments and before one can return to fun activities.

A trained and skilled minimally invasive surgeon can offer a great deal of experience in cancer surgery. Dr. Sasse trained at the Lahey Clinic, the premier surgical fellowship training program for colon and rectal surgery in the United States and one of the most recognized centers around the world. A great number of people fly to the Lahey Clinic from all over the world including the Middle East and Europe to undergo colorectal procedures from this prostigious and renowned faculty. The advances in minimally invasive surgery are well known and given that only two fellows graduate from this program annually, they are among the most sought after colon and rectal surgeons in the country. Dr. Sasse performed over a thousand colon and rectal resections during his residency and fellowship training and has performed thousands more minimally invasive colorectal resections over the last twelve years. The skill set involves recognition of the boundaries of the tumor, the application of the “no touch” technique, freeing up the tumor and its surrounding tissues carefully to obtain the best oncologic cure and performing the delicate anastomosis or reconnection of the colon with maximum safety. The incisions, the pain, narcotic use, complications and recovery time are all minimized.

The best news is the cancer cure rate is at least as high as it was with the old conventional open surgery.  Numerous studies demonstrate equivalent, if not higher capture rates and tumor margins achieved with minimally invasive surgery in experienced hands such as Dr. Sasse’s.  So the best treatment is also the least invasive treatment.