Some of the
following surgical procedures are
featured in the Video Clips on this website.
To visit our Surgical Video Clips
area, click
here.
The Center
for Minimally Invasive Surgery at Monmouth offers patients advanced laparoscopic
procedures, including
These state-of-the-art
techniques undoubtedly improve the quality of
life for patients. By healing
quicker and beginning therapy and
rehabilitation sooner, these individuals
are on the road to recovery
within a matter of days - if not hours - after
their surgical
procedure.
What is Colectomy?
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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About Laparoscopic
Colectomy
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.
Are You a Candidate
for Laparoscopic Colon Resection?
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.
How is Laparaoscopic
Colectomy Performed?
"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.
What are the
Advantages of the Laparoscopic Approach
to Colectomy?
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
How
is the Need for Surgery Determined?
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.
Preparing for
Surgery
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.
What if the Surgery
Cannot be Completed Laparoscopically?
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.
What are the
Potential Complications?
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.
What Can I
Expect After Surgery?
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.
