Posted on: October 6, 2017

Breakthrough Bowel Cancer Surgery

Innovative Bowel Cancer procedure makes headlines…

The work of St Mark’s Hospital, TASER, an innovative minimally invasive surgical technique, has been featured in the press. The Mail on Sunday and it’s digital counterpart, the Daily Mail, explored the benefits of this fantastic piece of research.

People with a high risk of bowel cancer can benefit from a new technique that could spare them major, life-changing surgery. The procedure, which is a world first, involves removing large growths by a minimally invasive technique. These tube-like growths, called polyps, form on the lining of the large bowel.

They are common, affecting 15 to 20 per cent of Britons, and they don’t usually cause symptoms. But they can become cancerous – so if they are discovered, they must be removed. Usually, polyps are small and are burnt or cut away during a colonoscopy procedure, via a thin flexible tube passed into the back passage.

However, in about one per cent of patients they can grow to a very large size, sometimes covering the entire circumference of the rectum.

The entrance to St. Mark's Hospital
St Mark’s Hospital – Home to the creation of TASER

Not only does this cause bleeding, but removing these larger polyps means cutting away a significant part of bowel wall, and stitching it back together. This can sometimes create a permanent narrowing, which means the bowel cannot function properly, and waste may be blocked.

TASER (Transanal Submuscosal Endoscopic Resection)

Now, London-based surgeons have pioneered a new, far less invasive technique that enables even very large polyps to be removed.

TASER has been developed by doctors at St Mark’s Hospital, and more than 40 patients have already been treated successfully. Instead of needing a major operation and permanent stoma, the patient stays in hospital for just a couple of nights.

The breakthrough is a huge step forward, said consultant colorectal surgeon Janindra Warusavitarne at St Mark’s Hospital in London. Mr Warusavitarne, who has pioneered the technique with his colleague Professor Brian Saunders, added: ‘Until now, patients with large, benign polyps were left with a stoma due to a condition that was exactly that – benign – and something that wasn’t yet life-threatening. If, on the other hand, you have advanced cancer, you can argue there is a clear benefit for having radical surgery.’

In the new procedure, in which two doctors operate at the same time, the patient is given a general anaesthetic before a tube is inserted into the rectum, through which the surgical instruments can be introduced.

TASER – Minimally Invasive Surgery

The rectal wall is made up of four layers: the lining, or mucosa, which produces a slippery, gel-like substance call mucus to helps waste move smoothly through the tract; the submucosa, which houses the blood vessels and nerves; and beneath these the muscular layer, then a fatty layer. Previously, surgery would have involved cutting away all four layers. TASER allows fluid to be injected beneath the submucosa lifting it away from the muscle.

The polyps grow from these upper layers which surgeons are able to cut them away, leaving the lower layers intact.

One doctor operates instruments that exposes the polyps base, while another uses cutting tools to carefully remove the growth. The mucosal layers are able to regenerate without the hindrence of a stitch which can form inflexible scar tissue. After healing, the rectum functions normally, with bowel habits returning to normal after about six weeks.

Mr Warusavitarne said: ‘Before, we would have removed so much of the rectum wall that it would have made functional tasks, such as going to the loo, either very painful or impossible. Now we can remove even large polyps intact.’

This is one example of the brilliant research projects completed at St Mark’s Hospital to help improve the lives of those suffering from bowel disease.

Read about the projects and research the hospital carries out…

 The original article is accessible here: Daily Mail –