There may be alternatives to colorectal surgery, depending on your condition.
The type of condition you have will determine whether there are alternatives to surgery. If you have bowel cancer, there are several alternatives to open colorectal surgery that you could discuss with your doctor.
Removing polyps which may be cancerous during colonoscopy
If your doctor finds a polyp (a small growth on a stem), during a colonoscopy they may be able to remove it completely during the procedure. Colonoscopy is a day procedure with a short recovery time, a low risk of complications and is relatively low cost. A biopsy will show whether the polyp/s are cancerous.
Endoscopic mucosal resection for large polyps or early colon cancer
If your surgeon isn’t sure that the cancerous tissue can be safely removed with a standard colonoscopy, they may be able to remove it using a similar procedure called ‘endoscopic mucosal resection.’
Your surgeon uses an endoscope to remove the cancer and a small amount of the lining of your colon. There’s a chance that the cancer will come back and a risk of perforating the bowel, so you’ll need to discuss your individual risks with your surgeon.
Compared to open surgery, the risk of complications is lower, recovery time is faster and it could be done as a day procedure. It also costs less than open surgery.
Your surgeon may recommend this procedure if you’re not well enough for open surgery.
Minimally invasive (keyhole) surgery for early colon cancer
This is another alternative to open surgery for removal of cancerous polyps or lesions. Your surgeon makes several small incisions in your abdominal wall, inserting instruments and a camera attached to a video monitor. Your surgeon will also remove lymph nodes in the area to see if the cancer has spread.
This surgery is less invasive than surgery that uses a large incision. It may take longer, but your recovery time should be faster, there’s less scarring, a lower infection risk and it may be cheaper too. Its effectiveness in treating cancer is comparable to open surgery.
This procedure can also be performed using a robotic technique. Robotic surgery for colon cancer is a recent development that’s not yet widely available. Miniature robotic arms are inserted through a few tiny openings in your abdomen. It has similar benefits to minimally invasive and endoscopic colon surgery, but the procedure tends to take longer and cost substantially more. Only a few surgeons in Australia are trained in this type of surgery and it doesn’t appear to offer benefits over normal keyhole surgery.
Alternatives to open colorectal surgery for non-cancerous conditions
There are alternatives to open surgery for some other colon conditions. Ask your surgeon what, if any, are available for your condition.
With any of these alternatives to open surgery, it’s possible your surgeon will have to change to open surgery if there are problems during your procedure.