Surgery at Institut Curie

Curie expertise

Surgery is one of the primary treatments for cancer. The main challenge of surgery is the complete ablation of the disease while respecting the functions of various organs. Surgery is one of the modalities of personalized treatment and can be combined with radiotherapy and/or chemotherapy depending on the case, before (neoadjuvant) or after (adjuvant) surgery.
Institut Curie is the first center in France specializing in surgical treatments of breast cancer (about 4,000 cases treated per year), eye cancers (between 500 and 600 cases in France treated per year, of which 80% are managed by Institut Curie), and retroperitoneal sarcomas (about 80 cases a year treated for these rare cancers). It is also internationally recognized for the management of ENT cancers (ears, nose, throat), thyroid cancers, sarcomas of the soft tissues of limbs and abdomen (non-bone tissues), cancers of the digestive system (esophagus, stomach, small intestine, colon-rectum, anus, liver, pancreas, and bile ducts), gynecological cancers (endometrium, cervix, ovaries, tubes, vulva and vagina).
The Department of Surgery of Institut Curie has two locations: Paris and Saint-Cloud. It includes nearly sixty surgeons, who all specialize in cancer management.
All patient files are discussed in a multidisciplinary consultation meeting attended by all those involved in cancer treatment. Therefore, the treatment offered to you is always individualized and optimized. In some more complex cases, several surgeons must intervene. This is due to the over-specialization of the surgeons of Institut Curie, who are trained to provide you with the most modern treatments.
Scientific data has made it possible to identify the concept of expert centers in the management of cancers. Thus, a minimum number of cases managed (surgical thresholds) is recommended by health authorities. It has therefore been proven that the volume of care, the specialization of the care teams, access to innovation, research, and support care constitute an added value in the care of cancer patients.

Surgical management

Putting the patient at the center of the therapeutic process, healing and rebuilding, mitigating as much as possible the possible consequences of surgical treatment - these are the objectives of the surgery teams of Institut Curie.
The operating theater of Institut Curie consists of 11 rooms in Paris, completely renovated in 2018, and 5 rooms in Saint-Cloud, constituting a modern and efficient technical platform, which provides access to the most innovative techniques.
You will be offered non-robotic laparoscopic surgery (via small orifices), which is approved for certain surgical procedures in cancer (colorectal cancer, liver surgery, certain gynecological cancers).
The Paris site treats breast cancer, gynecological cancers, ENT cancer, skin cancer, digestive system cancers, non-bone sarcomas, ophthalmological adult and child cancers, as well as offers reconstructive surgery, when necessary. The Saint-Cloud site takes care of breast, gynecological, ENT, skin cancers, certain sarcomas and their reconstruction.

Anesthesia and postoperative follow-up

Before the operation, an anesthesia consultation is necessary to assess the patient's general state of health, detect possible risk factors, and adapt the anesthesia techniques accordingly. The information on the anesthesia method (local or general) is provided to the patient during this consultation. The following information is also shared - management of postoperative pain, time of preoperative fasting, cessation or continuation of usual medications, possible access to hypnosis. For major surgery, particularly in gynecological surgery and hepatic surgery, an Improved Rehabilitation in Surgery (RAC) course in collaboration with anesthesiologists allows for faster post-operative recovery and limits the length of hospital stay.
For long and difficult interventions or for frail patients, hospitalization in a continuous care unit (light resuscitation) may be necessary. This information will be shared during the consultation.
At the end of the operation, the patient is taken to the recovery room where they are constantly monitored. During this phase, each patient is monitored and observed thanks to high-performance, computerized monitoring techniques. Management of pain and any other medical problem is also an integral part of the treatment plan. The recovery room is located within the operating theater, allowing the surgeon to come and see the patient in the event of an immediate post-operative surgical problem.

The operation

Detailed information about the operation will be shared with you by your surgeon during the pre-operative consultation. As often as possible, you will go to the operating theater standing up, accompanied by one of Institut Curie stretcher bearers. You will be welcomed at the waiting room at the entrance to the operating theater before accessing your surgery room. The nursing team will pick you up and direct you to your surgery room. Within the operating room you will meet many staff members (operating room nurse, nurse anesthesiologist, nursing students, the anesthesiologist, your surgeon, the resident and their assistants). For your safety, you will be asked many questions in the course of interactions with these staff members.
The surgical intervention can be diagnostic (diagnosing the disease) or therapeutic (treatment of the disease). In the therapeutic context, surgery can target the organ affected by the disease itself (the tumor), the neighboring nodes (in which the cancer cells may have migrated), or distant organs (metastasis).

Outpatient surgery

Institut Curie favors outpatient surgery as much as possible in order to limit the length of patient hospitalization and allow them to better manage the postoperative period in a private and family environment. In this case, the patient is operated on during the day and can return home after the procedure, without spending the night at the hospital. You must be accompanied by another person if you wish to leave the outpatient surgery department following the procedure.
Outpatient surgery is in particular set up for interventions in ophthalmology, senology (breast cancer), digestive surgery, and ENT. The post-operative follow-up is then carried out remotely, in connection with the healthcare team.

Reconstructive surgery

Reconstructive surgery has become an integral part of the management of cancer patients. It is no longer just a question of treating pathologies, but also of offering patients the possibility of healing with as few physical after-effects as possible. Depending on the various specialties and cases, this surgery can be performed at the same time or as a second operation.
Reconstructive surgery at Institut Curie is performed by plastic surgeons or "organ" specialists (breast surgeons, ENT surgeons). They decide on the best technique to be implemented in order to reduce the after-effects of treatments. This technique will be explained to you during your pre-operative appointment. The expertise of Institut Curie in this field is recognized as being of the highest order.
At the end of the pre-operative consultation, your surgeon will be able to direct you, depending on the cases and your requests, to so-called resource people, including an advising nurse who will be able to go over the various information explained by your surgeon and answer your practical questions, the dieticians in the event of malnutrition, addictionologists to help you with withdrawal(s), pain management specialists, and patient associations. We can offer you many different kinds of help.