Abdomino-perineal resection of the rectum
The abdominoperineal (AP) resection of the rectum is performed when the bowel cancer is so low in the pelvis that it is not possible to remove it and rejoin the bowels inside, or the patients pre-operative bowel function (continence) is so poor that the outcome of an operation to remove the rectum and rejoin the bowel would be certain to be incontinence.
Abdominoperineal resection for a low rectal cancer
The first part of the operation to remove the rectum involves placing the TAMIS port inside the muscular floor of the pelvis after closing the anus.
The rectum is then removed by dividing its attachments to the pelvic side wall.
Following this wound where the anus used to be is closed and the bowel is brought out onto the skin as a colostomy
At the end of the operation the rectum containing the tumour and all of the surrounding fat is sent to the pathology department so that the final stage of the cancer can be determined.
The stage of the cancer is very important and used to inform the decision to give post operative chemotherapy or not.