Dr. Solon Gonçalves Souza Menezes
Professor of Surgery — FAMED UFU · Robotic Surgery Certification (Intuitive / Albert Einstein Hospital) · Practices at Hospital UMC and Hospital Mater Dei Santa Genoveva, Uberlândia, Brazil · +55 (34) 99341-0915
Digestive system cancer can originate in different organs — colon, rectum, stomach, esophagus, pancreas, liver, or biliary tract (gallbladder and bile ducts) — and the surgical indication depends on the organ involved, the disease stage at diagnosis, and the patient's clinical condition. In general, when the tumor is localized and can be completely removed with disease-free margins, surgery tends to be the foundation of curative-intent treatment, sometimes combined with chemotherapy and, in some cases, radiation therapy before and/or after the operation.
In the colon and rectum, surgery removes the intestinal segment containing the tumor along with the surrounding lymph nodes, sometimes requiring a temporary or permanent diversion of the intestinal flow through a stoma. In the stomach, gastrectomy (partial or total) is always accompanied by removal of regional lymph nodes. In the esophagus, esophagectomy removes the affected segment and reconstructs the digestive tract. In the pancreas, a pancreaticoduodenectomy (Whipple procedure) or distal pancreatectomy are the most common procedures, depending on tumor location. In the liver, hepatectomy is indicated for both primary tumors and metastases originating from other organs. In the biliary tract, the approach ranges from a simple cholecystectomy to more extensive resections involving partial liver removal.
In cases of uncontrollable disseminated disease, curative surgery is generally not indicated. The decision about indication, extent, and timing of surgery is always individualized and discussed by a multidisciplinary team.
The process, from evaluation to returning to your routine.
Multidisciplinary Evaluation
The case is discussed between surgeon, medical oncologist, radiologist, and, when indicated, radiation oncologist.
Staging Workup
CT, MRI, endoscopy, and, in select cases, diagnostic laparoscopy, to determine the extent of the disease.
Surgery
Via open, laparoscopic, or robotic approach depending on individual indication, to remove the tumor with clear margins and regional lymph nodes.
Recovery
Hospital monitoring, pain control, early mobilization, and gradual reintroduction of food.
Follow-up
Gradual, with follow-up visits to assess recovery and plan any additional treatment.
Common questions about oncologic surgery.
How long does the surgery take?+
It varies considerably by organ and extent of resection — from about 1 to 3 hours for more limited procedures (like a cholecystectomy) to 6 hours or more for more complex surgeries, such as esophagectomy, pancreaticoduodenectomy, or hepatobiliary resections. The exact time can only be estimated after an individual evaluation.
What type of anesthesia is used?+
These procedures are performed under general anesthesia, with a prior pre-anesthesia evaluation to check the patient's clinical condition and define specific care for each case.
How long will I be hospitalized?+
It depends on the organ operated on and the surgical approach: more limited procedures may involve 2 to 5 days of hospitalization, while more extensive surgeries — such as esophagectomy, pancreaticoduodenectomy, or complex hepatobiliary resections — typically require 7 to 14 days, potentially longer if complications arise.
Will I feel pain after surgery?+
Some degree of postoperative pain is expected and is managed with hospital analgesia and, later, oral medication. Intensity and duration vary by person and tend to be lower with laparoscopic and robotic approaches compared to open surgery.
Will I need drains or tubes?+
In many cases, yes, temporarily — to monitor bleeding, leakage of secretions (such as bile or pancreatic fluid), or for nutritional support in the first few days. The need and duration depend on the type of surgery.
Will the scars be large?+
It depends on the approach: open surgery leaves a larger incision, while laparoscopic and robotic approaches use multiple small incisions. Not every case is eligible for a minimally invasive approach — this depends on stage, tumor location, and individual clinical factors.
How long will I be off work?+
It varies by type of surgery and occupation, ranging from about 3 to 4 weeks for more limited procedures to 2 or 3 months for more extensive surgeries. The timeline should be defined individually with your surgeon.
When can I resume physical activity and lifting?+
Generally, patients are advised to avoid physical strain and lifting weight for about 4 to 6 weeks after minimally invasive surgery, potentially extending to 8 to 12 weeks after more extensive open surgery. Clearance for more intense exercise is progressive and individualized.
What are the possible risks and complications?+
As with any medium- or large-scale digestive surgery, there are risks described in the medical literature, including bleeding, infection, anastomotic or secretion leakage (fistula), injury to nearby structures, pulmonary complications, and thromboembolic events, among others. Rates and specific complication types vary by organ, disease stage, and extent of resection — these should be discussed individually with your surgeon.
Are there contraindications for surgery?+
Yes. Generally, uncontrollably disseminated disease outside the organ of origin, inability to fully remove the tumor while preserving sufficient organ function, and clinical conditions that don't allow for a safe major surgery are factors that may contraindicate or delay the operation.
Will I need chemotherapy or radiation therapy in addition to surgery?+
It depends on the tumor type, the organ involved, and the disease stage. In many scenarios, treatment is indicated before surgery (neoadjuvant) and/or after (adjuvant) to reduce recurrence risk. This is determined together with the oncology team.
Who else is involved in my treatment besides the surgeon?+
Care typically involves a multidisciplinary team, which may include a medical oncologist, radiologist, radiation oncologist, anesthesiologist, nutritionist, and, when applicable, ostomy care nursing specialists.
Is robotic surgery always the best option?+
Not necessarily. The robotic approach is one of three possible options (along with open and laparoscopic), and its indication depends on the organ, tumor location and stage, and the patient's clinical factors. The choice of technique is always individualized.
Hospital facilities in Uberlândia, Brazil.
Hospital Mater Dei Santa Genoveva
Av. Vasconcelos Costa, 967 — Martins, Uberlândia-MG
Open in Google Maps →Content reviewed by Dr. Solon Gonçalves Souza Menezes — CRM-MG 79366, RQE 60355 (GI Surgery), RQE 44656 (General Surgery). Professor of Surgery at FAMED-UFU and Supervisor of the General Surgery Medical Residency Program at HC-UFU. ORCID. Last reviewed: September/2026.
- Feng Q, Yuan W, Li T, et al. Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol. 2022;7(11):991-1004. doi:10.1016/S2468-1253(22)00248-5
- Barchi LC, Jacob CE, Bresciani CJC, et al. Minimally invasive surgery for gastric cancer: time to change the paradigm. Arq Bras Cir Dig. 2016;29(2):117-120. doi:10.1590/0102-6720201600020013
- Dias AR, Ramos MFKP, Szor DJ, et al. Robotic gastrectomy: technique standardization. Arq Bras Cir Dig. 2021;33(3):e1542. doi:10.1590/0102-672020200003e1542
- Valukas CS, Zaza NM, Vitello D, et al. A Comparative Analysis of Open Versus Minimally Invasive Pancreatoduodenectomies. J Surg Oncol. 2024;131(5):816-826. doi:10.1002/jso.27992