Sphincter Saving Surgery In India

When a person has colorectal cancer in the lower part of the colon, the rectum and the anus are often both taken out. If the anus is taken out, the patient usually needs a permanent colostomy, which is a bag attached to the abdominal wall that holds stool.

Our colon and rectal surgeons can now do a more advanced type of surgery that gets rid of the need for a permanent colostomy for some low rectal cancers. This procedure, which is called “sphincter-sparing surgery,” makes it safe to remove the tumor and “saves” the anal sphincter muscle.

What is Sphincter Saving Surgery

Rectal cancer surgery is more difficult than colon cancer surgery. Dr. Vinay Samuel Gaikwad is a talented cancer surgeon who has had substantial education and training. He has extensive clinical expertise spanning over two decades and has been affiliated with some of India’s most prestigious institutions in the past. He has been demonstrated to be the most appropriate way to obtain the best potential outcomes in lower rectal cancer when cancer is close to the anus or anal sphincter. 

The anal sphincter is a circular band of muscles that wraps around the anus. Its purpose is to produce excellent bowel control. Traditional surgery for a patient with a rectal tumor/growth near the anal sphincters may need the removal of the anal sphincters. The patient would have a stoma on the abdomen wall for the rest of his life. The stoma is protected by a pouch that collects faeces from the bowel. The patient will need to empty the pouch on occasion.


Benefits of Surgery to Save the Sphincter

The Sphincter Saving Surgery lets you keep control of your bowel movements. It also:

  • Boosts the quality of your life
  • Provides cancer cure rates equal to more extreme surgery
  • It gets rid of the need to remove the sphincter muscles and anus, so you can eventually go back to using your anus to pass stools.

A special surgical strategy may be necessary for a patient who has rectal cancer that is located close to the anal sphincters in order to achieve both the total removal of cancer and the preservation of the anal sphincters at the same time. 

There are a variety of surgical therapy options available for patients with rectal cancer.

  • Transanal local excision (or trans-anal endoscopic microsurgery, TEMS)
  • Low excision of the anterior
  • Very little cutting was done to the front (with or without trans-anal total mesorectal excision, TaTME)
  • Resection of the abdominal wall and perineum
  • Exenteration of the pelvic region

When to be performed Sphincter Saving Surgery

Depending on the progression of the disease, sphincter-saving therapies may consist of surgery alone, or they may comprise surgery in conjunction with chemotherapy, radiation, or both. It is essential to have a proper pre-operative staging in order to formulate an appropriate treatment strategy for each individual patient. 

Trans-rectal/Endorectal Ultrasonography (ERUS), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography scan are the pre-surgical diagnostic tools that are included in the complete and cutting-edge pre-operative staging technology (PET-CT scan). If pre-operative staging reveals that the cancer is at an early stage, the patient may be eligible for treatment with trans-anal local excision/TEMS, which does not need an incision to be made in the abdominal wall during surgery. 

By utilizing specially developed surgical equipment and having an expert colorectal surgeon do the procedure, this surgical method may be carried out through the anus. In order to eliminate the need for a permanent stoma, colo-anal anastomosis might also be used to treat the majority of the bigger cases of low rectal cancer. 

In addition, the technique known as a complete mesorectal excision, or TME is considered to be the gold standard of surgical therapy. This will necessitate the removal of the rectum in addition to the lymph nodes that are located in the surrounding envelope.


Why is it performed?

When the tumor is situated in a region that is very low in the rectum or is close to the anal sphincters, people who have colorectal cancer face the most difficult challenges throughout the surgical treatment process. This group of patients often receives an offer from the general surgeon to have both the rectal tumor and the anus removed in the same procedure. 

On the other hand, if the anus is removed, the patient will almost always require a stoma that is permanent. Sphincter Saving Surgery is a type of colorectal surgery that is performed by a colorectal surgeon who specializes in the procedure. The goal of this surgery is to spare the anal sphincters from removal.

For this surgical technique to be successful, it is necessary to protect the nerves that are located nearby in order to keep bowel, bladder, and sexual function regular after the operation. To protect the sphincter as much as feasible, it may be necessary to employ a mix of several cutting-edge technologies. Because having a stoma can be an annoyance, colorectal surgeons provide sphincter-saving procedures to rectal cancer patients.

These treatments allow the patient to maintain the functionality of the anus. The surgical procedure can be carried out by the abdominal or the anal route (using trans-anal total mesorectal excision, or TaTME), or it can be carried out using a combination of the abdominal and the anal approach. Because of recent developments in surgical technology and methods, it is now possible for a particularly educated surgeon to undertake sphincter-saving surgery by employing laparoscopic/keyhole surgery or even robotically assisted surgery.

Surgeon for a Sphincter Saving Surgery In India

Dr. Vinay has been practicing medicine for more than 21 years, therefore he brings a wealth of expertise with him. He is very skilled in the performance of some of the most cutting-edge cancer operations available, including HIPEC and PIPAC.