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Last updated: 15-Oct-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Cancer Surgeon (GI)
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ Google: 4.9 from 53 reviews (Gota clinic) · 5.0 from 25 reviews (Apollo, Bhat)
In short
Three things set the first step: which side of the colon is blocked, how unwell the patient is, and whether the bowel is close to bursting.
A blocked left colon in a stable patient can often be opened with a metal stent. The planned cancer operation then follows within one to two weeks.
The robot is not used in the emergency itself. It comes in later, for the planned operation, once the bowel is open and the patient has recovered.
Before any decision about stent or surgery, the patient is made safe. A CT scan with contrast then shows where the blockage is and how serious it is.
| CT finding | Why it matters |
|---|---|
| Where the blockage is. | Right side and left side are handled differently. |
| How stretched the start of the colon is. | Heavy stretching means it may burst soon. Urgent surgery is needed. |
| A thickened bowel wall. | It points to a tumour as the cause. |
| Free air or fluid in the belly. | It suggests the bowel has already burst. |
| Spots in the liver, lungs or belly lining. | It shows whether the cancer has spread. |
| Length of the tumour. | A long tumour is less suited to a stent. |
An unstable patient or a bowel about to burst needs an operation now. A stable patient gives time to choose between a stent, a stoma or removal.
| Situation | Usual first step |
|---|---|
| Shock, signs of a burst bowel, or a bowel about to burst. | Emergency operation. |
| Blocked right colon. | Removal of the right colon, with the bowel joined. Keyhole if stable, open if not. |
| Blocked left colon, stable and fit. | A metal stent to open it, then a planned operation. |
| Blocked left or low colon, not fit for a big operation. | A stoma to relieve the blockage, without removing the growth yet. |
| Blocked left colon, unstable. | Emergency removal, usually with a stoma. |
A stent is a mesh tube of metal. It is passed through a scope from below, across the narrowed part. It then opens up and lets the bowel empty. A mark is tattooed just below the growth, so the surgeon can find it later.
A stent suits a blockage on the left side, in a stable patient, with a growth that is not too long. It needs a team that can place stents. It is not used for a blocked right colon, a burst bowel, several narrowings, or a bowel about to burst.
In trials, a stent followed by a planned operation gave the same long-term cancer results as an emergency operation. It also meant fewer stomas and a shorter stay. Uncovered stents are preferred, as they slip less.
A stent has its own risks. It can make a small hole in the bowel, slip out of place, bleed or block again. These are explained before it is placed.
For a patient too unwell for a big operation, a stoma relieves the blockage first. The growth is removed later, once the patient is stronger.
A stoma is an opening of the bowel on the belly, into a bag. A loop of colon or small bowel is brought out through a small cut. It may also be used when a stent is hard to place low down, or when treatment before surgery is planned. Most loop stomas are simple to close later.
For a blocked right colon, the right colon is removed and the bowel joined. For a blocked left colon in a fit patient, a longer length of colon may be removed so that the bowel can be joined safely.
In a patient who is in shock, or whose belly is soiled, the bowel is not joined. The growth is removed, the end of the colon is brought out as a stoma, and the lower end is closed. This is called Hartmann’s operation. The stoma is usually reversed three to six months later, when the patient is fit. Some patients never have it reversed.
The rule in an emergency is simple. The safest operation for that patient is chosen, not the neatest one.
The robot is kept for the planned operation after a stent or a stoma. It removes the same bowel and lymph nodes as keyhole or open surgery.
A stretched, fragile bowel leaves little room to work. So an emergency is usually done open or by keyhole, not robotically. Once a stent has opened the bowel, the planned removal follows in one to two weeks. Iron is given if blood counts are low, and a scan at about a week confirms the bowel has emptied.
That planned operation is chosen like any planned colon cancer operation: robotic, keyhole or open. How the operation is matched to the tumour site is on the robotic colon cancer surgery by tumour site page. A left-sided blockage most often leads to a left hemicolectomy or a sigmoid colectomy.
Stent placement needs both an endoscopy and an X-ray team, which not every hospital has. Insurance approval can also affect timing. Ask how a stoma would be cared for, and whether and when it would be closed.
No. An unstable patient or a bowel about to burst needs one. A stable patient may have a stent or a stoma first.
A stable patient with a blockage on the left side and a growth that is not too long. It is not used for the right side.
No. The emergency is usually done open or by keyhole. The robot may be used for the planned operation that follows.
Not always. A stent often avoids one. A stoma is more likely when the patient is very unwell, and it is often temporary.
Usually within one to two weeks, once the bowel has emptied and the patient is stronger.
Colon cancer surgery at this centre is covered on the robotic colon cancer surgery page. For questions before you travel, call +91-63590-11009.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of CT and colonoscopy reports, second opinions and follow-up.
Apollo Hospital, Bhat, Gandhinagar
Admission, emergency and planned surgery, robotic, keyhole and open, and inpatient care.
A family member admitted with a bowel blocked by a growth? The CT report and any colonoscopy or blood reports can be sent ahead on WhatsApp, so the discussion starts with them already read. The plan is decided after examination, by the treating team. Call +91-63590-11009 Send the CT report
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