Keyhole surgery
Laparoscopic abdominoperineal resection
Keyhole removal of the lower rectum, anal canal and sphincter for a tumour sitting too close to the anus to be removed any other way. A permanent colostomy is part of it.
In plain language
What this operation is
An abdominoperineal resection removes the lower rectum together with the anal canal and the sphincter muscle. Because the sphincter is removed, the bowel cannot be rejoined, and a permanent colostomy is created on the abdominal wall.
It is not the first choice. It is the correct operation when the tumour involves the sphincter or sits so close to it that an anterior resection could not remove the cancer completely.
That distinction is decided from MRI, and it is discussed openly before anything is booked — including what living with a colostomy involves.
Who it is for
When this operation is advised
- Cancer of the low rectum involving or very close to the anal sphincter
- Recurrent rectal cancer where sphincter preservation is not possible
- Some anal canal cancers where other treatment has not cleared the disease
And when it is not. Where the tumour is far enough from the sphincter, an anterior resection is preferred precisely because it avoids a permanent stoma.
How it works
From assessment to follow-up
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01
Staging
Colonoscopy with biopsy, MRI of the rectum and CT. The MRI is what determines whether the sphincter can be saved.
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02
Treatment sequence
Chemotherapy or radiotherapy is often given before surgery for low rectal cancer.
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03
Stoma planning
The colostomy site is marked and explained before the operation, with time to ask questions.
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04
The operation
Through small ports for the abdominal part, with a perineal approach to remove the anal canal.
Afterwards
What recovery involves
Recovery differs between patients. What follows is what usually happens — your own timeframe is given at discharge, based on the operation you actually had.
- This is a major operation and hospital stay reflects that.
- The perineal wound needs its own care and takes time to heal.
- Stoma care is taught before discharge, and support continues afterwards.
- Most people return to work and normal activity with a colostomy once it is established.
When to go to hospital instead
Fever, increasing pain, or a stoma that stops working needs urgent hospital assessment.
Common questions
Questions patients ask
Anything not covered here can be answered at the consultation.
01 Why can’t the bowel be rejoined?
Because the operation removes the anal sphincter — the muscle that provides control. Without it there is nothing to join to, and no way to control motions. That is the reason the colostomy is permanent rather than temporary.
Stoma02 Why is this operation needed instead of anterior resection?
Only when the tumour involves the sphincter or lies so close to it that an anterior resection could not remove the cancer completely. Where a safe margin is possible, anterior resection is preferred precisely because it avoids a permanent stoma.
Choice03 Can I live a normal life with a colostomy?
Most people do — working, travelling and exercising once the stoma is established and they are confident with the care. Training begins before discharge and support continues afterwards.
Living with it04 অপারেশনের পর কি স্থায়ীভাবে ব্যাগ ব্যবহার করতে হবে?
এই অপারেশনে হ্যাঁ। কারণ পায়খানা ধরে রাখার মাংসপেশি টিউমারসহ ফেলে দিতে হয়, তাই পেটের দেয়ালে স্থায়ী কোলোস্টমি করতে হয়। অপারেশনের আগেই এ বিষয়ে বিস্তারিত বুঝিয়ে বলা হয় এবং ব্যাগ ব্যবহারের প্রশিক্ষণ দেওয়া হয়।
কোলোস্টমিNext step
Bring your reports to a consultation
Often one visit is enough to know whether an operation is needed at all.