Colorectal Cancer · Colon Cancer Surgery · Pune

Colon Cancer Surgery

Name: Colon Cancer Surgery — Dr. Vinod T. Gore
Creator: Dr. Vinod T. Gore

Robotic & Open Colectomy · Complete Mesocolic Excision

Most colon cancers are highly curable with surgery — and unlike rectal cancer, the majority of patients need no stoma. Dr. Vinod T. Gore performs robotic and open colectomy with complete mesocolic excision (CME) and D3 lymphadenectomy for the best oncological outcome.

Robotic Colectomy · da Vinci Xi No Stoma — Most Patients CME · D3 Lymphadenectomy FARIS Edinburgh

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Rectal Cancer Surgery - Dr. Vinod T. Gore

90%+

Cure rate when found at Stage I

Most

Patients need no stoma

12+

Lymph nodes harvested (quality marker)

300+

Robotic procedures by Dr. Gore

Understanding Colon Cancer

What is colon cancer?

The colon is the longest part of the large bowel. Colon cancer usually begins as a small growth called a polyp on the inner lining, which can slowly turn cancerous over several years. Because the colon sits in the open abdomen — not deep in the pelvis like the rectum — the surgeon can remove the affected segment and rejoin the bowel immediately, which is why most colon cancer patients do not need a stoma.

Tumours behave differently depending on their location. Right-sided cancers (caecum and ascending colon) often cause anaemia and tiredness with little change in bowel habit, while left-sided and sigmoid cancers more often cause a change in bowel habit, visible bleeding or obstruction.

Colon cancer is among the most common gastrointestinal cancers in India and is rising in adults under 50. When caught early it is highly curable, which is why screening colonoscopy from age 45 — or earlier if symptoms appear — is so important.

Key Facts

90%+

Cure rate when detected at Stage I

Most

Patients need no permanent stoma

12+

Lymph nodes is the minimum quality standard for a good cancer operation

Age to begin screening colonoscopy (earlier with family history)

~30

Days, on average, from first visit to surgery at Silver Leaf Clinic

Warning Signs

Symptoms of colon cancer

Symptoms depend on where the cancer is. Never ignore a change in bowel habit, bleeding, or unexplained anaemia — early colon cancer is highly curable.

Iron-deficiency anaemia and persistent tiredness (common with right-sided tumours)

A lasting change in bowel habit — diarrhoea, constipation or narrower stools — over 4 weeks (common with left/sigmoid tumours)

Blood in the stool, or dark/altered blood mixed with motion

Unexplained weight loss

Abdominal pain, cramping or bloating

A feeling of a lump or mass in the abdomen, or incomplete emptying

Many early colon cancers cause no symptoms at all — a screening colonoscopy from age 45 is the most reliable way to catch them early.

Disease Staging

Colon cancer stages & outlook

Staging guides treatment. A CT scan of the chest, abdomen and pelvis, colonoscopy with biopsy, and a CEA blood test are used to stage colon cancer before surgery.

Stage	Classification	Description	5-yr Survival
Stage I	T1–T2, N0, M0	Confined to the bowel wall. Surgery alone is usually curative.	90–95%
Stage II	T3–T4, N0, M0	Grown through the wall but no lymph nodes involved. Surgery; chemo for high-risk features.	75–85%
Stage III	Any T, N1–N2, M0	Spread to nearby lymph nodes. Surgery followed by adjuvant chemotherapy.	50–75%
Stage IV	Any T, Any N, M1	Spread to liver, lung or peritoneum. Combined chemotherapy and surgery for selected patients (incl. HIPEC).	Variable

Treatment Pathway

From diagnosis to recovery

A clear, evidence-based pathway — with every decision made together at the tumour board.

Step 01

Staging & MDT

Colonoscopy with biopsy, CT chest/abdomen/pelvis and CEA. Every case is discussed at the multidisciplinary tumour board before any decision.

Step 02

Surgery First

Unlike rectal cancer, most colon cancers are treated with surgery first — a robotic or open colectomy with complete mesocolic excision and D3 lymphadenectomy.

Step 03

Pathology Review

The removed specimen is examined for margins, tumour stage and lymph node count (minimum 12). Results are reviewed again at the tumour board.

Step 04

Adjuvant Chemotherapy

For Stage III — and selected high-risk Stage II — chemotherapy begins about 4–6 weeks after surgery to reduce the risk of recurrence.

Step 05

Surveillance

Regular follow-up with CEA, CT scans and surveillance colonoscopy to detect any recurrence early.

Step 06

Survivorship

Ongoing support, lifestyle guidance and screening advice for you and your family.

Surgical Treatment

Colectomy — removing the cancer completely

The operation removes the segment of colon containing the tumour together with its blood supply and lymph nodes. The type of colectomy depends on where the cancer is.

Modern Standard · Robotic

Robotic Colectomy with CME & D3

Complete Mesocolic Excision · Central Vascular Ligation

Complete Mesocolic Excision (CME) removes the colon along with its entire mesocolic envelope — the membrane containing the draining lymph nodes — following the correct embryological planes, with central ligation of the feeding vessels (D3 lymphadenectomy). Performed robotically, the magnified 3D view and wristed instruments allow this meticulous, intact dissection with less blood loss, smaller incisions and a faster recovery. CME with adequate node harvest is strongly linked to better long-term survival.

Removes the complete mesocolic package intact
Central vascular ligation & D3 nodal clearance
Higher lymph node yield — a key quality marker
Smaller incisions, less pain, faster recovery
No stoma in routine cases

Caecum · Ascending Colon

Right Hemicolectomy

Removes the right side of the colon for tumours of the caecum, ascending colon or hepatic flexure. The small bowel is joined to the transverse colon (ileo-colic anastomosis) — no stoma in routine cases.

No stoma in routine cases
Ileo-colic anastomosis
Robotic or laparoscopic approach

Descending Colon

Left Hemicolectomy

Removes the left side of the colon for tumours of the descending colon or splenic flexure, with the bowel rejoined immediately.

Bowel rejoined immediately
No stoma in routine cases
Minimal-access approach

Sigmoid Colon

Sigmoid Colectomy

Removes the sigmoid colon — the most common site of left-sided colon cancer — with a primary anastomosis.

Common for sigmoid tumours
Primary anastomosis
Robotic precision for the pelvic brim

Multiple or Hereditary

Extended / Subtotal Colectomy

For multiple tumours, very large cancers, or hereditary conditions (such as Lynch syndrome or FAP), a larger length of colon is removed.

For multiple or hereditary cancers
Tailored to each patient
Genetic counselling offered

Will I Need a Stoma?

Most colon cancer patients do not need a stoma

Usual Outcome

No stoma

In routine colon cancer surgery the two ends of bowel are rejoined straight away (anastomosis), so normal bowel function continues and no stoma is needed.

Occasionally

Temporary stoma

A temporary stoma is only sometimes needed — for example in emergency surgery for a blocked or perforated bowel, or to protect a higher-risk join. It is usually reversible.

You will always know in advance. If there is any chance of a stoma, Dr. Gore and the specialist stoma nurse will explain it fully before surgery — including siting, day-to-day care, and reversal planning.

Patient Questions

Frequently asked questions — colon cancer

Will I need a colostomy bag after colon cancer surgery?+

In most cases, no. For colon cancer the bowel is usually rejoined immediately, so no stoma is needed. A temporary stoma is only occasionally required — for example in emergency surgery for an obstructed bowel — and is usually reversible. (A permanent colostomy is mainly a concern for very low rectal cancer, not colon cancer.)

What is Complete Mesocolic Excision (CME) and D3?+

CME means removing the colon along with its entire surrounding membrane (the mesocolon) and the lymph nodes within it, following natural tissue planes. D3 refers to clearing the lymph nodes right up to the origin of the feeding blood vessels. Together they give the most thorough cancer clearance and are linked to better survival.

Is robotic colectomy better than open or laparoscopic surgery?+

All three can cure colon cancer. Robotic and laparoscopic (keyhole) surgery offer smaller incisions, less pain and faster recovery. The robot adds 3D magnified vision and wristed instruments for very precise dissection. Open surgery remains the right choice for some very large or complex tumours. Dr. Gore selects the safest approach for each patient.

Will I need chemotherapy?+

It depends on the stage. Stage I and most Stage II cancers are cured by surgery alone. Stage III (lymph nodes involved) and high-risk Stage II usually benefit from adjuvant chemotherapy, starting about 4–6 weeks after surgery.

How long is recovery after colon surgery?+

With robotic or keyhole surgery most patients are walking within a day, eating within 2–3 days, and home in about 4–6 days. Full recovery takes around 4–6 weeks.

Should my family be screened?+

If you have colon cancer, first-degree relatives should discuss earlier screening. Some colon cancers are linked to inherited conditions such as Lynch syndrome or FAP — genetic counselling and testing can be arranged when appropriate.

Book a Consultation

Colon cancer consultation, Pune

Bring your colonoscopy report, CT scan and biopsy. Dr. Gore will review everything personally and explain your options clearly — including whether a stoma is needed (it usually is not).

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Silver Leaf Clinic

88558 10010

☎️

Silver Leaf Clinic Landline

+91 20 6768 9704

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Dr. Gore Direct / WhatsApp

84118 08284

📍 Silver Leaf Clinic

511, City Centre, Solapur Road, Opp. Vaibhav Theatre, Hadapsar, Pune 411028

📍 Open in Google Maps

OPD Hours

Monday – Saturday10:00 AM – 6:00 PM

SundayBy Appointment

Also See

Robotic GI Surgery HIPEC Surgery Rectal Cancer