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An elderly patient presented with abdominal pain and anemia, raising concern for an underlying gastrointestinal pathology. At an earlier stage, the patient had refused colonoscopy and biopsy due to fear of pain and the possibility of major surgery.

With progression of symptoms, the need for evaluation became essential. After detailed counselling and reassurance, the patient agreed to undergo colonoscopy and biopsy, which confirmed carcinoma of the colon. With further reassurance and discussion, the patient subsequently consented to definitive surgical management.

The patient underwent a laparoscopic radical hemicolectomy. This minimally invasive approach ensured adequate oncological clearance while significantly reducing surgical trauma.

The recovery was remarkable. Despite undergoing major cancer surgery, the patient experienced minimal pain, early mobilisation, and was discharged on postoperative day 5 in stable condition.

For this patient, laparoscopy truly transformed the experience of cancer surgery—turning fear into confidence and leading to a smooth, happy recovery.

💡 Key Message

Fear often delays diagnosis and treatment in colon cancer. With advances in laparoscopic surgery, even major procedures can now be performed with less pain, faster recovery, and excellent outcomes.

From fear to happy recovery — this is the real impact of laparoscopy in modern cancer surgery.

📞 Contact

Dr. Pavan Kumar C. G.
Consultant Surgical Oncologist
Advanced Laparoscopic Cancer Surgeon
Hubli–Dharwad

📱 Phone: 9130056215

An elderly patient presented with abdominal pain and anemia, prompting further evaluation. Colonoscopy with biopsy revealed a diagnosis of carcinoma of the ascending colon, and staging workup suggested a locally advanced disease (cT3N1M0) without distant metastasis.

The patient underwent a laparoscopic right radical hemicolectomy with D3 lymphadenectomy, including central vascular ligation (CVL). This approach ensures en bloc resection of the tumor along with complete mesocolic excision and high ligation of feeding vessels, facilitating optimal lymph node clearance.

🔬 Oncological Principles

Adequate oncological surgery in colon cancer is defined not only by removal of the primary tumor, but also by:

• Complete mesocolic excision (CME)
• D3 lymph node dissection with central vascular ligation
• Clear proximal and distal margins

These principles are critical in achieving better long-term oncologic outcomes, including reduced recurrence and improved survival.

⚙️ Advantages of the Laparoscopic Approach

In appropriately selected patients, laparoscopic surgery offers:

✔ Enhanced magnified visualization for precise dissection
✔ Reduced intraoperative blood loss
✔ Lower postoperative pain
✔ Faster recovery and early mobilisation
✔ Shorter hospital stay
✔ Comparable oncological outcomes to open surgery

This case highlights how minimally invasive surgery can be safely applied even in elderly patients with locally advanced disease, without compromising oncological clearance.

A 56-year-old male patient presented with a right renal mass consistent with renal cell carcinoma (RCC), measuring 10 × 8 cm, involving the upper pole and extending to the renal hilum.

Given the tumor location and extent, nephron-sparing (partial) surgery was not feasible, and the patient was planned for laparoscopic right radical nephrectomy.

The procedure was performed using a minimally invasive laparoscopic approach, allowing precise dissection and safe control of the renal hilum while adhering to oncological principles. The surgery was completed successfully without intraoperative complications.

The patient had an excellent postoperative course, with minimal pain, early mobilisation, and rapid recovery, and was discharged on postoperative day 5.

This case highlights the role of laparoscopic radical nephrectomy in managing large renal tumors where nephron-sparing is not feasible, offering the benefits of minimally invasive surgery while ensuring oncological adequacy and patient-centered recovery.

A 68-year-old female with squamous cell carcinoma of the lower esophagus (cT3N0M0) developed an iatrogenic esophageal perforation following endoscopy, leading to mediastinitis.

The patient was initially managed conservatively. An attempt at endoscopic stenting was made; however, stent placement was not feasible as the distal lumen could not be identified endoscopically. By day 3, in view of worsening mediastinitis and a large perforation involving more than 50% of the esophageal circumference, a decision was made to proceed with surgical exploration.

Given that the patient remained hemodynamically stable but showed progression of local sepsis, she underwent an emergency transthoracic esophagectomy with gastric conduit reconstruction. The procedure allowed definitive control of the source of contamination and restoration of gastrointestinal continuity.

The patient tolerated the surgery well. The postoperative course was complicated by pulmonary issues, which were managed effectively with intensive care support and dedicated pulmonary care.

With gradual recovery, the patient improved clinically and was discharged on postoperative day 12, tolerating oral intake and in stable condition.

This case highlights the importance of timely surgical intervention in esophageal perforation associated with malignancy, particularly when conservative and endoscopic measures are not feasible. In selected patients, emergency esophagectomy can be life-saving, offering both sepsis control and definitive oncologic management.

A 34-year-old woman, evaluated for persistent bronchitic symptoms, was incidentally found to have an anterior mediastinal mass on imaging. Further diagnostic workup confirmed a thymoma, with no associated paraneoplastic manifestations.

Following appropriate preoperative optimisation, we proceeded with a right-sided Video-Assisted Thoracoscopic (VATS) thymectomy.

Advantages of the Minimally Invasive Approach

In appropriately selected patients, VATS thymectomy offers distinct benefits:

✔ Reduced postoperative pain
✔ Early mobilisation
✔ Lower wound morbidity
✔ Shorter hospital stay (discharged on postoperative day 5)
✔ Oncologic adequacy maintained

Minimally invasive thoracic surgery continues to demonstrate that oncologic precision and patient-centered recovery can coexist.

Surgical oncology is evolving — not only in achieving disease control, but in enhancing the quality of recovery for our patients.

We managed a 28-year-old male patient diagnosed with a primary mediastinal germ cell tumor who had completed four cycles of BEP chemotherapy. Post-treatment assessment demonstrated normalization of tumor markers, with persistence of a residual mediastinal lesion on imaging.

Operating on sarcomas continues to be one of the most rewarding experiences for a surgical oncologist. Each case demands not only technical mastery but also deep respect for complex anatomy and multidisciplinary collaboration.

Recently, a 50-year-old woman presented with a large retroperitoneal liposarcoma, posing considerable anatomical and technical challenges. Managing such tumors requires meticulous preoperative planning and precise intraoperative execution.

The ESOPEC trial (NEJM 2025) is a landmark phase III study directly comparing perioperative FLOT chemotherapywith neoadjuvant CROSS chemoradiotherapy in resectable esophageal and gastroesophageal junction adenocarcinoma.

The PORTEC-3 trial continues to shape our understanding of adjuvant therapy in high-risk endometrial cancer. With updated 10-year follow-up data, it provides valuable insights into survival outcomes and the role of molecular classification in guiding treatment.

🔑 Key Highlights

Chemoradiotherapy vs Radiotherapy Alone
Long-term benefit in overall survival (OS) and recurrence-free survival (RFS) persists with combined modality treatment.

p53-abnormal (p53-abn) tumors
Patients derive a substantial survival advantage with chemoradiotherapy.

POLE-mutated cancers
Show an excellent prognosis regardless of treatment, supporting treatment de-escalation in this subgroup.

MMR-deficient (MMRd) & NSMP groups
Outcomes highlight the need for immunotherapy approaches and further risk stratification in these subsets.

🎥 Watch my detailed discussion on this trial and its clinical implications on my Journal Club Oncology channel: 👉 PORTEC-3 Trial Discussion – Dr. Pavan Kumar

A 50-year-old woman presented with a left lumbar paraspinal schwannoma, a benign nerve sheath tumor located deep in the retroperitoneal space. MRI revealed two well-defined lesions measuring 10 × 5 cm, extending from L2 to L5, with no intracanalicular extension. She successfully underwent excision of the tumor through a transperitoneal minimally invasive approach, which provided excellent visualization, precise dissection, and safe tumor removal.

Although retroperitoneal masses are often considered a relative contraindication for laparoscopic surgery, in this case the patient underwent safe paraspinal mass removal with no intraoperative complications, minimal blood loss, and faster recovery compared to conventional open surgery.

The postoperative course was uneventful; the patient recovered smoothly and was discharged on the 4th postoperative day without neurological deficits or perioperative complications.