• The type of cancer and its stage;
• The location of the tumour;
• The size of the tumour;
• The purpose of the surgery;
• The patient’s general state of health and their wishes.

The most frequently used surgical techniques are the following:

Conventional open surgery

This is performed by way of an incision that may be dozens of centimeters in length. Procedures include laparotomy for an opening of the abdomen and thoracotomy for an opening of the thorax.

Endoscopic or minimally invasive surgery

This procedure uses small openings in conjunction with an endoscope, a fine instrument equipped with a camera that makes it possible to view the inside of the body on a screen. The endoscope is introduced into the body through natural channels (mouth or anus for the digestive tract for example) or through small incisions of about 1 cm.

Using small incisions, specialized surgical instruments are passed through tubes to reach the area to be operated on. Depending on the area of the body concerned, endoscopy takes different names:

• Laparoscopy is performed via the abdominal cavity and permits visualization and intervention in the digestive, gynecological and urological system;
• Thoracoscopy permits visualization and intervention in the thorax.

Laser surgery

This form of surgery destroys cancer cells through the action of intense light delivered by a laser. In cancer treatment, laser surgery can be used to:

• Destroy cancer cells;
• Remove a tumour or abnormal tissue on or near the surface of an organ or skin;
• Relieve symptoms caused by the tumour, such as bleeding, pain, shortness of breath or an obstruction.

Although laser surgery cannot be used to treat all types of cancer, it can be useful in the following cases:

• Precancerous conditions of the cervix such as cervical intraepithelial neoplasia (CIN) and carcinoma in situ of the cervix;
• Esophageal cancer;
• Cancer of the vocal cords;
• Lung cancer;
• Precancerous conditions of the vagina or vulva;
• Cancer of the penis;
• Non-cancerous skin tumours.

Robotic surgery

In robotic surgery, also known as laparoscopic robot-assisted surgery or computer-assisted surgery (CAD), the surgeon sits at a station near the patient, who is lying on the operating table. The surgeon uses a computer to move robotic arms attached to surgical instruments inside the patient’s body.  Robots are able to perform very precise movements.

Sources (in French only):

Oncologie chirurgicale

Dans quels cas a-t-on recours à la chirurgie ?

Quelques mots sur la chirurgie oncologique

Chirurgie : types et objectifs

Traitement chirurgical