Dr Kaiser on Advances With Minimally Invasive Surgery in CRC

"That’s the difference [between open surgery and minimally invasive surgery: with minimally invasive approaches], we can do all the work internally…and we only need to make an opening somewhere [on the abdomen] to retrieve the organ once it should be removed from the body. That prevents the bowels from becoming traumatized by being exposed."

Andreas M. Kaiser, MD, a professor and chief of the Division of Colorectal Surgery in the Department of Surgery at City of Hope, discussed how advances with minimally invasive surgery have affected the colorectal cancer (CRC) treatment paradigm in an interview with OncLive® during CRC Awareness Month, which is observed each March.

Minimally invasive surgery has transformed surgical techniques for CRC, particularly abdominal procedures, Kaiser began. Historically, patients who underwent surgeries like gallbladder removal or appendectomy were left with large 6-to-10–inch scars, despite these organs being only a few inches in size, he shared. In contrast, modern minimally invasive surgical techniques allow for the removal of large organs, such as the colon, through incisions as small as 8 to 12 mm, Kaiser said.

The key advantage of minimally invasive surgery is that it enables surgeons to perform internal resection and anastomosis without exposing the bowels to external trauma, Kaiser stated. Unlike open surgery, where bowel exposure can lead to desiccation and irritation, minimally invasive approaches help maintain a protected environment, Kaiser explained. This also allows surgeons to observe normal bowel motility, which is typically disrupted following major incisions, he added.

Despite these advantages, open surgery remains necessary in select cases, Kaiser noted. Patients with a history of multiple prior surgeries or complications may require a traditional open surgical approach, particularly if they have significant adhesions or if previous minimally invasive attempts were unsuccessful, he said. Ultimately, the choice between minimally invasive and open surgery for patients with CRC depends on individual patient factors, ensuring the safest and most effective approach for each case, Kaiser concluded.