Colon & Rectum
¿What is a Colectomy?
A colectomy is the removal of a part of the colon (a partial colectomy) or of the entire colon (a total colectomy). This is also known as the large intestine, and may be called a bowel resection. Colectomy is used to treat a variety of bowel disease including cancer, polyps, recurrent infections or bleeding. The portion of the colon removed depends on the nature of the disease.
¿What Differentiates a Laparoscopic Procedure from an Open Colectomy Procedure?
The procedures differ in both size of incision, means of removal, and technical performance. The laparoscopic colectomy utilizes three to five small incision in your lower stomach, the surgeon will then pass the medical instruments through these cuts to perform the surgery. The stomach is then filled with gas and expanded, making it easier for the surgeon to see and maneuver. The surgeon will use these tools to remove the diseased part of the bowel, and sew the healthy parts of the bowel back together in a process called “anastomosis”. The surgeon removes the laparoscopic tools, and sews close the small cuts.
In an open colectomy, your surgeon will make a larger cut into your stomach which can be in some cases over 12 inches. The surgeon will manually survey your colon to identify the part which is diseased. The colon is clamped on both sides to close it off, while the surgeon removes the diseased portion. If there is enough of a healthy large intestine and colon left, your surgeon will sew or staple the healthy ends together…this is the standard procedure. If for whatever reason there is not enough healthy large intestine intact, you may be required to have a colostomy (a procedure used to form an alternative channel for waste to leave the body).
A laparoscopic colectomy is a relatively quick procedure with an expected time range of 1 to 4 hours and a much quicker recovery with substantially less pain than open colectomy.
Reasons for a Colectomy:
There may be any number of reasons why the doctors at MIB Surgery may recommend a patient to have a laparoscopic colectomy. These range from diseases such as cancer or blockages and injuries damaging the integrity of the large bowel. The complete list of symptoms requisite for a colectomy is as follows:
- A block in the intestine due to scar tissue
- Colon cancer
- Diverticular disease (disease of the large bowel)
- Injuries that damage the large bowel, Familial polyposis
- gastrointestinal bleeding
- Twisting of the bowel (volvulus)
- Ulcerative colitis
- Intussusception (one part of the intestine pushes into another)
- Precancerous polyps (nodes)
- Severe infection, etc.
Before the Surgery:
Because this procedure requires an incision into the bowels of the patient, a strict prep regimen is required. A few days before the date of the procedure the patient will receive a bowel prep. This includes drinking fluids and taking laxatives/enemas. This is requisite to ensure that the colon is free of stool for the surgery. On a case by case basis you may be asked to drink only clear liquids such as broth, clear juice, and water the day before.
On the day before the surgery do not drink anything after midnight, including water. Sometimes you will not be able to drink anything for up to 12 hours before surgery.
After the Surgery:
You will wake up in the recovery room, and will be moved to a room. You must remain inside the hospital until it has been confirmed that you’ve regained full rectal function. This may range anywhere from 2 to 7 days on an individual basis and will be reviewed daily by your doctor. If the procedure was an emergency colectomy expect to stay longer and be under closer observation by your doctor.
Further conditions and examples requiring a longer than standard hospital stay include: if a large amount of the intestine was removed, or if the patient develops any complications.
By the first – third day post-operation the patient will likely be cleared to drink clear liquids (water). The doctor or nurse will slowly add thicker liquids, progressing to soft foods as the patients’ bowel begins to fully regain its’ function.
Most patients who receive a large bowel resection make a full recovery. Even with a colostomy most people can quickly return to the activities which they were performing before their surgery. This includes most sports, travel, gardening, biking, hiking, and other outdoors activities. If there is a long-term or chronic condition present in the patient such as cancer, Chron’s disease, or ulcerative colitis you may require ongoing observation or medical treatment decided upon a case by case basis.