Skilled cancer surgeons put patients’ lives first — but they also stick to the “leave no trace” philosophy. They want to leave as little post-surgical evidence of their work as possible. That’s why so many embrace minimally invasive surgery, such as laparoscopic procedures.

While traditional open surgery uses one large incision, laparoscopic surgery uses special instruments that enter the body through several small incisions. Surgeons view their work through a tiny camera inserted in the body.

Joshua D.I. Ellenhorn (Photo by Darrin S. Joy)

These surgeries seek to lessen blood loss and other complications, reduce post-surgical pain and speed recovery.

Now, City of Hope surgeons have found another instance when minimally invasive methods make sense.

A team of clinical researchers led by Joshua D.I. Ellenhorn, M.D., associate professor and chief of the Division of General Oncologic Surgery, looked at the records of 78 patients who underwent surgery to remove stomach cancer. Of those, 30 had laparoscopic surgery and the rest had open surgery.

They found that laparoscopic surgery was just as effective in removing the cancer, but it had fewer complications and quicker recovery.

Unfortunately, laparoscopic surgery currently isn’t as well-accepted in the U.S. and Canada as open surgery for stomach cancer.

“It’s a technically demanding procedure, and it can take longer than open methods,” he said. Surgeons also worry that removal of lymph nodes, called lymphadenectomy, may be less effective with laparoscopic surgery, he added.

Surgeons perform lymphadenectomy to check the lymph nodes surrounding a tumor for cancer cells. The presence of tumor cells in a lymph node can mean the cancer has begun to spread and needs more aggressive treatment.

“One of the key points we make in the study is that we can do lymphadenectomy just as well with laparoscopic surgery — both robotic-assisted and standard laparoscopic — as we can with open surgery,” said Ellenhorn. Proving that should give other surgeons confidence in the minimally invasive procedure and lead to wider use of the method. And that could mean more comfort for patients.

Ellenhorn would like to see laparoscopic surgery adopted as the standard for stomach cancer.

“The potential benefit in reduced suffering and recovery time for patients is well worth the added difficulty of the procedure,” he said.

City of Hope surgeons use both standard laparoscopic and robotic-assisted techniques to perform minimally invasive stomach cancer surgeries.