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Surgery for Rectal Cancer: Stages II, III, IV

Resection: The Procedure In The Operating Room

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In the operating room during a resection:

  • You will be hooked up to several monitoring devices such as a heart monitor and a blood oxygen monitor. 
  • You will fall asleep immediately when the anesthesiologist starts injecting the anesthesia drug. 
  • Once asleep, a tube will be placed in your throat to keep it open during the surgery.
  • The surgery is usually performed by a colorectal or general surgeon and a surgical team including  a scrub nurse to help with the equipment and the anesthesiologist who will monitor your vital signs.
  • The operation involves general anesthesia so there is no pain during the procedure. 
  • What happens during the operation depends on whether the tumor is in the rectum or colon, its size, and whether it has spread.
    • The operation will remove a segment of the rectum which has the cancer as well as a small length of healthy bowel around it. 
    • The two parts of the intestine are reconnected to each other (the procedure is known as an anastomosis). If the two ends of the rectum cannot be sewn together, an opening (a stoma) is made which connects the bowel to the outside of the body so that waste can pass out of the body and into a bag. This is known as a colostomy. If a colostomy is required, it is not likely to be permanent.  (To learn about ostomies, click here.)
    • During the surgery:
      • Biopsies are generally done  to confirm the staging and to determine whether the cancer has spread, including a lymph node dissection to determine if the cancer has spread to the lymph nodes.
      • If the cancer has spread to other organs (metastasized): if only a small number of metastases are present in an organ such as the liver, lungs or ovaries, they may be removed during the surgery.

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