Expert: Claes-Gustaf Nordquist, M.D. - 7/19/2006

Question
Please help.
77 yr. old male - per biposy - 3in mod adenocarcinoma of upper left ascending colon per colonoscopy.  saw colon/rectal surgeon.
He palns barium air enema night before surgery to see rest of bowel next week night before surgery to see rest of bowel that coudn't be viewed because of this tumor in way.  
He states open incision is needed vs laproscopic new way because of anomally of partial duplication of collecting system. doesn't want to rish nicking it.  This means major surgery vs 3 little open incisions!  
Does this sound right?  
Can I slow this down and get second opinion?  Should I have barium air exam first, go to another surgeon, and do you suggest MRI or PET scan too?
Is this anomally reason enough to have major surgery vs laproscopically?  
at any age - but Being 77 - you can understand why this is important to feel okay about this before heading off to major surgery without hearing someone else say - no, this is the the right course now to go - and yes, only open incision can be done vs laproscopically.

thank you so much for your time.   
D  

Answer
Honestly I do not think he has much choice! What you are describing to me is a case for MAJOR SURGERY NOT keyhole surgery! Not yet anyway - anything may be possible in the future, but not yet! The surgeon MUST be able to inspect the whole area, which means open surgery, quite apart from the anomaly! So I fully understand why the surgeon wants to do it this way. It is always your right to ask for a second opinion, however I do not believe you have much time available. The surgery may not be an emergency operation but it probably should not wait long! I do hope all goes well! Unfortunately in matters like this no one can guarantee it!