Laparoscopic Colon Surgery
Definition: The large intestine, or colon, is the lower part of the digestive tract. Diseases of the colon are common, and more than one-half million surgical procedures are performed in the United States every year to treat them. Indications for colon resections include:
- Colon cancer
- Diverticular disease (diverticulitis)
- Gastrointestinal bleeding
- Inflammatory bowel disease (Crohn’s disease, Ulcerative colitis)
- Intestinal polyps
- Large bowel obstruction
During a colon resection, the diseased portion of the bowel is removed and the two healthy sections of the colon are reattached. This is called an end-to-end anastamosis. If an anastamosis is not possible because of the extent of the disease or its location, a colostomy is then created. A temporary colostomy is made when the colon is severely inflamed and needs time to heal after surgery. An anastamosis is performed once the inflammation has resolved, approximately 3-6 months.
Reason for procedure:
- Colon cancer
- Diverticular disease (diverticulitis)
- Gastrointestinal bleeding
- Inflammatory bowel disease (Crohn’s disease, Ulcerative colitis)
- Intestinal polyps
- Large bowel obstruction
Symptoms
- Fever, chills
- Nausea, vomiting, diarrhea
- Bloating, unable to pass flatus
- Abdominal pain and/or distention
- Bleeding
Treatment options
- Nonsurgical option: A majority of colonic pathology requires surgery. For some diseases where observation is undertaken, surgery may be eminent if symptoms don’t resolved. Generally a few days of bowel rest (nothing to eat) and intravenous hydration with or without antibiotics are necessary. For those who do not resolve, or if an obstruction is due to a mass, tumor or inflammation with infection, surgery is indicated.
- Surgical option: Laparoscopic resection of the affected portion of colon or the conventional open resection
Risks associated with surgery:
- Infection of the skin
- Intra-abdominal infection
- Breakdown of colonic connection (anastomosis) or leakage of fluid from colon
- Postoperative ileus (the intestines slow down/stop working for several days)
- Intestinal injury
(This is only a partial list of potential complications)
Pre-operative preparation
- May include blood work, urinalysis, abdominal x-rays, abdominal CT scan and colonoscopy
Average hospital stay:
- Varies amongst patients, but the average patient stays hospitalized for about 1-5 days without surgery and 4-8 days with surgery.
Type of anesthesia required:
- Laparoscopic surgery requires general anesthesia which blocks pain and keeps you asleep throughout the entire surgery.
Recovery period: Once you have undergone laparoscopic surgery, your recovery period is usually shortened when compared to conventional open surgery. Most patients can usually go home within 1 to 2 days after the procedure although every case is different. You will be given pain medication along with a laxative to prevent constipation. Your activity may be limited to light lifting (no more than 20 lb) for one month.