Sphincter Saving Surgery

Rectal Cancer & Robotic Surgery

The location changes everything. The rectum is located in the narrow pelvic basin, surrounded by nerves vital for urinary and sexual function. Dr. Srinivas Bojanapu specializes in Robotic Total Mesorectal Excision (TME), prioritizing "Sphincter Preservation" to avoid a permanent bag whenever oncologically safe. We treat the cancer without compromising your dignity.

Robotic TME Avoid Stoma Multidisciplinary Care

90%+ Sphincter Saved

3D Robotic Vision

ERAS Rapid Recovery

Symptoms & The "Piles" Confusion

⚠️ Critical Note: Rectal cancer is frequently misdiagnosed as Piles (Hemorrhoids) because both cause bleeding. If you have bleeding without pain or a change in bowel habits, you need a specialist exam, not just ointments.

We are seeing Rectal Cancer in younger patients (30-50 years). Do not ignore these signs:

Altered Bowel Habits: Constipation alternating with diarrhea for >2 weeks.
Tenesmus: A constant urge to pass stool even when the bowel is empty. This happens because the tumor mimics stool in the rectum.
Narrow Stools: Stools that look "pencil-thin" due to obstruction.
Bleeding: Fresh bright red blood (unlike colon cancer which presents with dark/black stools).

The Anatomical Challenge & Robotic Solution

The human pelvis is a tight, cone-shaped space. In men, it is even narrower. Conventional open surgery struggles to reach deep into this basin to remove the tumor without damaging surrounding nerves.

[Image of human digestive system] Rectal Cancer Location Diagram

Fig 1. The Rectum sits deep in the pelvis. Robotic arms can navigate this tight space better than human hands.

Robotic TME: The Gold Standard

Total Mesorectal Excision (TME) is the Holy Grail of rectal cancer surgery. It involves removing the rectum along with its surrounding fatty envelope (mesorectum) intact, like removing a letter inside an envelope.

3D High-Definition Vision: We see nerves magnified 10x, allowing us to spare the tiny nerves responsible for bladder and sexual function.
7 Degrees of Freedom: The robotic wrist rotates 360 degrees, allowing us to suture deep in the pelvis.
Ultra-Low Anastomosis: We can join the bowel very close to the anal muscle, saving the natural passage.

Surgical Options Explained

The surgery depends on the tumor's distance from the anal verge (the opening).

Procedure Name	Tumor Location	Outcome
Anterior Resection (AR)	Upper Rectum	Tumor removed, colon joined to rectum. No Stoma.
Low Anterior Resection (LAR)	Mid Rectum	Colon joined lower down. Often requires a temporary safety bag (Ileostomy) for 6 weeks.
Ultra-Low Resection (ULAR)	Very Low Rectum	Technically demanding. We save the sphincter muscles. Temporary bag is mandatory.
APR (Abdomino-Perineal Resection)	Invading Anal Muscles	Rarely done today. Only if the sphincter is cancerous. Permanent Stoma bag required.

Patient Questions Answered

Will I need a permanent bag?

With Robotic Surgery, less than 10% of patients need a permanent bag (Colostomy). We fight hard to save the sphincter. However, we often use a "Temporary Loop Ileostomy" for 6 weeks to let the delicate internal join heal safely. This is reversed in a minor procedure later.

What is Neoadjuvant Therapy?

For Stage 2 or 3 rectal cancers, we often give Chemotherapy and Radiation *before* surgery. This shrinks the tumor, sterilizes the lymph nodes, and increases the chance of sphincter preservation. This is decided by our Tumor Board.

How long is recovery?

Hospital stay is typically 4-6 days. You are walking on Day 1. Full recovery takes about 3-4 weeks. If you have a temporary stoma, our specialized Stoma Nurse will train you on managing it easily before discharge.

Why do I need an MRI?

A high-resolution Pelvic MRI is the most critical test. It tells us exactly how close the tumor is to the "mesorectal fascia" (the safety margin). This guides whether we operate first or give radiation first.