Surgery to remove a small part of the bowel lining (local resection)

This surgery is for small, early stage colon cancers. Your surgeon removes the cancer from the bowel lining, along with a border of healthy tissue (margin). This is called a local resection. The surgeon uses a flexible tube called a colonoscope to do the operation. 

What type of surgery do I need?

The type of surgery you need for cancer of the large bowel (colon cancer) depends on:

  • the stage of your cancer
  • where it is in your colon

For a small early stage colon cancer, your surgeon might just remove the cancer from the bowel lining, along with a border of healthy tissue. This is called a local resection.

For larger cancers, your surgeon might remove the part of the bowel where the cancer is and join the 2 ends of your colon back together. This is called a colectomy.

Before a local resection

Your bowels need to be empty for a local resection.

To do this you take medications (laxatives) or an enema to empty your bowel the day before your test. You shouldn’t eat for 6 hours before and only drink clear fluids in this time.

You should get written instructions before your test about what you need to do.

How you have the surgery

You have this operation under general anaesthetic, or with a drug that makes you sleepy (sedation). The specialist doing the operation might be a surgeon, trained endoscopist or a bowel and stomach specialist (gastroenterologist).

The specialist uses a long, flexible tube called a colonoscope to do the operation. They place lubricating jelly on your bottom before inserting the colonoscope. They will then pump some gas (carbon dioxide) in to open up your bowel.

They put the colonoscope into your back passage and pass it along your bowel. The colonoscope has a camera at the end so the specialist can see pictures of the inside of your bowel on a TV monitor. 

The specialist uses the colonoscope to find the cancer. They then remove the cancer and a border of healthy tissue (margin) around the cancer. They do this by passing cutting instruments down the colonoscope.

They send the tissue that they remove to the laboratory.  A specialist doctor called a pathologist looks at the cancer cells under the microscope, to see how abnormal they are.

 Your surgeon may decide you need a second operation if the cells look very abnormal (high grade). This surgery aims to remove tissue that could contain cancer cells and lowers the chance of your cancer coming back.

Diagram of bowel cancer early resection
Last reviewed: 
12 Nov 2018
  • Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up
    R Libianca and others
    Annals of Oncology, 2010. Volume 21, Pages 70-77

  • Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the management of cancer of the colon, rectum and anus (2017) – diagnosis, investigations and screening
    C Cunnigham and others
    Colorectal disease, 2017. Volume 19, Pages 1-97

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