Types of surgery

Many different types of surgery may be used as part of a cancer treatment plan. Some surgeries remove tissue. For example, a laryngectomy is surgery to remove part or all of the larynx (voice box). Some surgeries make an opening in the body. For example, a colostomy is surgery to make an opening from the colon to the outside of the body through the abdominal wall.

The type of surgery and the way it is done will depend on the:

  • type of cancer
  • size and location of the tumour
  • stage of cancer
  • goals of treatment
  • person’s general health and preferences
  • facilities and experts available

Approaches to surgery

Surgeons choose a specific type of surgery to treat a cancer. Then they decide on the best approach to surgery. The surgical approach describes the way the surgeon reaches the surgical area (site) or organ.

The 2 main approaches to surgery are open surgery and minimally invasive surgery.

Open surgery uses a wide incision (cut) to reach and examine, remove or repair tissue. It is often called conventional, or traditional, surgery because it is a well-established approach to surgery.

Minimally invasive surgery uses approaches that do not need a large incision. The surgeon usually makes a small cut to place an endoscope (a small, flexible tube with a light and lens). The surgeon uses the endoscope to look at an area inside the body, and can use special instruments to remove or treat tissue. In general, recovery is faster and there is less pain with minimally invasive surgery. But this type of surgery cannot be used for all tumours.

In some cases, the surgery can be done through an opening or cavity in the body. For example, the surgeon may use a transoral approach to reach cancer in the larynx. Transoral means through the mouth. Sometimes prostate cancer can be treated with transurethral resection. This means that the prostate is removed through the urethra (the tube that carries urine from the bladder to the outside of the body).

Surgical techniques

The surgical technique refers to the steps in the surgery and the instruments used to do the surgery.

Radiofrequency ablation (RFA) uses a special probe to deliver radiofrequency waves that heat and destroy abnormal tissues. Find out more about radiofrequency ablation.

Cryosurgery uses extreme cold (liquid nitrogen or liquid carbon dioxide) to freeze and destroy abnormal cells. Find out more about cryosurgery.

Electrosurgery uses a high-frequency electrical current to destroy abnormal cells.

Radiosurgery uses highly focused high-dose radiation to destroy cancerous tissue.

Endoscopic surgery uses an endoscope that the surgeon places in the body through small incisions or a natural opening. The surgeon uses the endoscope to look at structures or organs or remove tissue. Different types of endoscopes are used to examine and treat different parts of the body. Find out more about endoscopy.

Robotic surgery is also called robot-assisted laparoscopic surgery or computer-assisted surgery. During robotic surgery, the surgeon sits at a station a short distance away from the person on the operating table. The surgeon uses a computer to move robotic arms that are connected to surgical instruments inside the person’s body.

High-intensity focused ultrasound (HIFU) uses ultrasound waves to create intense heat, which destroys tissue.

Laser surgery uses a laser beam to destroy abnormal cells. Find out more about laser surgery.

Mohs surgery removes a tumour little by little in layers. After each layer is removed, the doctor examines it under a microscope to look for cancer cells. Layers are removed until no cancer remains. Find out more about Mohs surgery.

Stereotactic surgery uses a CT scan or MRI to locate a tumour in 3-D space. It is used for accurate biopsies, to remove tumours or to precisely deliver radiation.

Percutaneous ethanol injection (PEI) uses an ultrasound or a CT scan to guide a needle through the skin to inject alcohol (ethanol) directly into a tumour.

Questions to ask about surgery

To make the decisions that are right for you, ask your healthcare team questions about surgery.

Expert review and references

  • American Cancer Society . Surgery. American Cancer Society. American Cancer Society (ACS). Atlanta, GA: American Cancer Society; 2011.
  • Gillespie,T.N. . Surgical Therapy. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: Chapter 11:pp.232-248.
  • Rosenberg,S.A. . Surgical oncology: general issues. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: Chapter25:pp268-278.