Laparoscopic Anterior Resection

Laparoscopic (keyhole) anterior resection performs the same operation as open anterior resection — Total Mesorectal Excision (TME) with sphincter-saving anastomosis — through 4–5 small incisions (5–12 mm) instead of a large abdominal cut. The rectum and its mesorectal envelope are removed and the colon is joined to the remaining rectum or anal canal.

Advantages Over Open Surgery

• Shorter hospital stay — 4–5 days vs 7–10 days for open surgery
• Less post-operative pain and faster mobilisation
• Smaller scars — 4–5 small holes vs a 15–20 cm midline incision
• Lower risk of wound infection and incisional hernia
• Equivalent long-term cancer outcomes (survival, local recurrence)
• Faster return to normal activities — 3–4 weeks vs 6–8 weeks

Robotic vs Laparoscopic Anterior Resection

Robotic-assisted surgery offers even greater precision in the narrow pelvis, potentially improving TME quality and preserving autonomic nerves. Laparoscopic anterior resection is technically feasible in the majority of rectal cancer patients at Charak Hospital. The approach is individualised based on tumour location, patient anatomy and surgeon expertise.