What is Sphincter Saving Surgery?

Sphincter saving surgery (SSS) removes the rectal tumour while preserving the anal sphincter muscles, allowing the patient to maintain normal bowel control without a permanent colostomy. Dr. Ashok Kumar is specially trained in this technically demanding surgery and has extensive experience from his career at SGPGI, Lucknow.

The key principle is Total Mesorectal Excision (TME) — complete removal of the rectum and its surrounding fatty tissue — combined with reconstruction of bowel continuity.

Techniques Used

• Low Anterior Resection (LAR) — for mid and upper rectal cancers; bowel joined above the sphincter
• Ultra-Low Anterior Resection — for low rectal cancers; coloanal anastomosis at the sphincter level
• Intersphincteric Resection (ISR) — for very low rectal cancers within 1–2 cm of the sphincter; inner sphincter removed but outer preserved
• Ileal Pouch-Anal Anastomosis (IPAA) — used after proctocolectomy for ulcerative colitis with cancer
• Laparoscopic Anterior Resection — minimally invasive approach where feasible

When is a Permanent Colostomy Still Needed?

Abdominoperineal Resection (APR) with permanent colostomy is required when the tumour directly invades the sphincter muscles and adequate clearance cannot be achieved while preserving sphincter function. Dr. Ashok Kumar carefully evaluates each patient with MRI staging and discusses all options with the patient before deciding on the surgical approach.