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Natural orifice treatment of rectal cancer

As innovation is constantly moving forward in the management of rectal cancer, Sunnybrook leads the way in safe innovative approaches that result in the best possible cancer outcomes with the absolute least invasive treatments possible.

With this in mind, the inception of natural orifice techniques in the management of rectal cancer have been developed and are currently being implemented at Sunnybrook.

Every rectal cancer is different and therefore every treatment strategy requires thoughtful consideration as to the best surgical approach for each individual patient.

For some very early stage rectal cancers and rectal polyps, natural orifice surgery or transanal minimally invasive surgery (TAMIS) allows the surgeon to precisely remove the tumour from within the rectum. This is done with special instruments to magnify and project the area onto a monitor and with long thin instruments the tumour is removed and the area is sutured. These patients, like Mike Calderone can walk out of hospital the very same day; they require no incisions at all to treat their rectal lesions.

This novel approach is changing rectal cancer management worldwide, says Dr. Shady Ashamalla

For larger rectal cancers, local removal with TAMIS is not appropriate and these patients historically require large open abdominal incisions in order to remove the rectum itself. At Sunnybrook we have implemented TaTME (transanal total mesorectal excision), which means we complete the same removal of the rectum, within which the cancer dwells, through natural orifice surgery with laparoscopic instrumentation. Once the cancer is removed the two ends are joined together (anastamosis) to make a new connection. This is all done through laparoscopic natural orifice surgery in order to avoid incisions and offer more magnified accuracy during the surgery.

This novel approach is changing rectal cancer management worldwide and provides new hope for patients with very low rectal cancers to avoid permanent pouches.

Whether you are you a surgeon that would like more information or a patient that would like to know if this technique is an option for you, please contact us for more detailed information.