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 At Monmouth Medical Center, we know that it’s results
that matter. That’s why we’ve become the regional
leader in the treatment of high risk colorectal cancer.
It’s why we
created the Patricia
Burton High Risk Colorectal Cancer Program,
which offers the only high risk familial colorectal cancer
registry in New Jersey. And why we built the state’s
only Multidisciplinary Gastrointestinal Tumor Team to meet
monthly to review ongoing cancer care.
The
fact is that we do it better. And we can prove it.
We not only perform more laparoscopic colorectal resections
than any hospital in the region, we also have the region’s
lowest conversion rate from laparoscopic to open colorectal
surgery (4% at MMC vs. 15% nationally). Just a few of the
reasons why we’ve earned the coveted Thompson 100 Top
Hospitals Performance Leaders award.
Colectomy, also known as colon removal or colon resection,
is the
surgical removal of the diseased part of the bowel, or
large intestine. The two remaining sections then are
sewn together. This
procedure is recommended for blockage of the intestine
due to scar tissue or deformities; bleeding, infection
or ulcers due to ulcerative colitis, cancer, precancerous
polyps, familial polyposis or traumatic injury. Each
year, more than 600,000 surgical procedures are performed
in the United States to treat a number of colon diseases.
Although surgery is not always a cure, it often is the
best way to stop the spread of disease and alleviate
pain and discomfort.
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The colon is the large intestine and forms the lower
part of your
digestive tract. The intestine is a long, tubular organ
consisting of
the small intestine, the colon and the rectum, which
is the last part
of the colon. In most laparoscopic colon resections,
surgeons operate through four or five small openings
(each about a quarter-inch long) while watching an enlarged
image of the patient's internal organs on a television
monitor. In some cases, one of the small openings may
be lengthened to 2 or 3 inches to complete the procedure.
Through the introduction of minimally invasive laparoscopic
colon surgery, surgeons can perform many common colon
procedures through these small incisions. Depending
on the type of procedure, patients may leave the hospital
in one to three days and return to normal activities
more quickly than patients recovering from open surgery.
Patients undergoing traditional colon surgery often face
a long and
difficult recovery because "open" procedures are
highly invasive. In
most cases, surgeons are required to make a long incision.
Surgery
results in an average hospital stay of five to eight
days and usually
six weeks of recovery.
Although laparoscopic colon resection has many benefits,
it may not be appropriate for some patients. Candidacy
for this procedure is
determined through careful medical evaluation by
a surgeon qualified in laparoscopic colon resection in
consultation with your primary care physician.
"Laparoscopic" and "open" colon surgery simply
describe the techniques asurgeon uses to gain access
to the internal surgery site. Most laparoscopic
colon procedures start the same way. Using a canula (a
narrow tube-like instrument), the surgeon enters the
abdomen. A laparoscope (a tiny telescope connected to
a video camera) is inserted through the canula, giving
the surgeon a magnified view of the patient's internal
organs on a television monitor. Several other canulas
are inserted to allow the surgeon to work inside and
remove part of the colon. The entire procedure may be
completed through the canulas or by lengthening one of
the small canula incisions.
Results may vary depending upon the type of procedure
and patient's
overall condition. Common advantages are:
- Less postoperative pain
- Shorter hospital stay
- A faster return to normal diet
- Quicker return of bowel function
- Quicker return to normal activity
- Better cosmetic results
Most diseases of the colon are diagnosed with one of
two tests: a
colonoscopy or barium enema. These tests allow the surgeon
to look inside of the colon. Sometimes a CT scan of the
abdomen will be necessary. Prior to the operation, other
blood tests, electrocardiogram (EKG) or a chest X-ray
might be required.
It is acceptable to shower the night before or morning
of the operation. The rectum and colon must be completely
empty before surgery. Usually, the patient must drink
a gallon of a special cleansing solution and may be required
to undergo several days of clear liquids, laxatives and
enemas prior to the operation. Oral antibiotics commonly
are prescribed. Your surgeon or his/her staff will give
you instructions regarding the cleansing routine to be
used. Follow your surgeon's instructions carefully. If
you are unable to take the preparation or the antibiotics,
contact your surgeon. If you do not complete the preparation,
it may be unsafe to undergo the surgery and it may have
to be rescheduled. While many medications can be continued
as usual, drugs such as aspirin, anti-inflammatory, blood
thinners and insulin are examples of medications which
may have to be decreased or temporarily stopped. Ask
your surgeon about any medications you currently are
taking.
In a small number of patients, the laparoscopic method
does not work effectively. Factors that may increase
the possibility of choosing or converting to the "open"
procedure may include obesity, a history of prior abdominal
surgery causing dense scar tissue , an inability to
visualize organs or bleeding problems during the operation. The
decision to perform the open procedure is a judgment
decision made by your surgeon either before or during
the actual operation. The decision to convert to an
open or conventional procedure is strictly based on
patient safety.
As with any operation, there is the risk of a complication.
However, the risk of one of these complications occurring
is no higher than if the operation were performed with
the conventional open technique. There is a slight
risk of bleeding or infection, which is present with
any operation and an even smaller risk of a leak where
the colon was connected back together. Injury to adjacent
organs such as the small intestine, ureter, or bladder
or blood clots to the lungs are possible complications
as well. It is important for you to recognize the early
signs of possible complications. Contact your
surgeon if you notice severe abdominal pain, fevers,
chills or rectal bleeding.
After the operation, it is important to follow your
doctor's instructions. Although many people feel better
in just a few days, remember that your body needs time
to heal. You are encouraged to be outof bed the day
after surgery and to walk. This will help diminish
the soreness in your muscles. You will probably
be able to get back to most of your normal activities
in one to two weeks time. These activities include
showering, driving, walking up stairs, work and sexual
intercourse. If you have prolonged soreness, or drainage
from any of your incisions, and are getting no relief
from the prescribed pain medication, you should notify
your surgeon. You should call and schedule a follow-up appointment
within two weeks of your operation.
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