Laparoscopic Colon Surgery
After discussing your colon problem, you and your doctor may decide that laparoscopic treatment is right for you. How well you prepare can affect the success of surgery. Make sure you understand all instructions your doctor gives you. If you're unclear about what to do, be sure to ask. To help prepare your body, you will be instructed on what to do before surgery. Follow these instructions carefully. Ask questions if something is unclear.
Preparing a Few Weeks Before Surgery
- Have a medical checkup. Have a thorough physical exam before surgery, as instructed by your doctor. This checks the health of your heart and lungs.
- Ask about medications. Tell your surgeon about all medications you take, and ask whether you should stop taking any of them. This includes prescription medications, aspirin, ibuprofen, and other over-the-counter drugs. Also, be sure to mention any herbs or supplements you take.
- Quit smoking. If you smoke, do your best to quit now. Smoking increases your risks during surgery and slows healing.
Preparing the Day Before Surgery
- Have only clear liquids. You will be told not to eat any solid foods and to drink only clear liquids on the day before surgery. These liquids include broth, plain tea, gelatin, and clear fruit juice. Any liquid that you can see through when it's held up to the light is considered clear.
- Do your bowel prep. To be sure your colon is clear of stool, you'll do a bowel prep the day before surgery. This involves drinking a liquid laxative, taking pills, using enemas, or using a combination of these methods. Ask your surgeon how many hours before surgery the bowel prep must be completed.
- Make sure your stomach is empty. Do not have anything to eat or drink, including water and chewing gum, after midnight the night before surgery. If you take any medication on a regular basis, ask your surgeon if you should take it during this time. If so, take the pills with small sips of water.
The Day of Surgery
When you arrive at the hospital, you will be asked fill out certain forms. You will then change into a gown. An IV (intravenous) line will be inserted into your arm. This provides fluids and medications. You'll meet with your anesthesiologist or nurse anesthetist to discuss the medication that helps you sleep during surgery. Ask any questions you have at this time. Before surgery begins, you'll be given general anesthesia to put you into a deep sleep. A soft tube called a catheter may be placed into your bladder to drain urine.
If Open Surgery Is Needed
During the procedure, the surgeon may find that it is safer to convert to open surgery. In most cases, this is because of a detail of anatomy that could not be seen on scans done before the surgery. It doesn't mean that anything went wrong. Conversion to open surgery is done to assure the best outcome for you. Before surgery you'll be asked to sign a release giving your consent for open surgery if it is needed.
During Your Surgery
- Your doctor makes several small incisions.
- A laparoscope (a thin telescope-like tube) is then placed into one of the small incisions. This allows your doctor to view the colon on a video monitor.
- The surgical tools are placed into the other incisions. (A larger incision may be made later to remove a part of the colon.
- The problem part of the colon is resected (removed). Sometimes the two ends of the colon are joined. This is called an anastomosis.
- Once surgery is done, you'll be taken to a recovery room.
Possible incision sites
Possible benefits of a laparoscopic approach:
- Less scarring
- Less pain
- Faster recovery
- Shorter hospital stay
- Quicker return to normal activity
Types of Colon Resection
The idea of having part of your colon removed may sound scary. But part or all of the colon can be resected (removed) without causing serious problems. After the section of bowel is removed, the two ends are then reconnected (anastomosis). Below are some of the surgeries that can be performed on the colon. The type of surgery depends on the location of the colon problem.
Right Hemicolectomy: Part or all of the ascending colon and cecum is removed. The colon is then reconnected to the small intestine.
Left Hemicolectomy: Part or all of the descending colon is removed. The transverse colon is then reconnected to the rectum.
Sigmoid Colectomy (Sigmoidectomy): Part or all of the sigmoid colon is removed. The descending colon is then reconnected to the rectum.
Segmental Resection: One or more short segments of colon are removed. The remaining ends of the colon are reconnected.
Risks and Complications
Risks and possible complications of colon surgery include the following:
- Injury to nearby organs
- Anastomosis that leaks or separates
- Blood clots
- Risks of anesthesia
- Temporary ileus (bowel muscles slow or stop, and gas and waste don't move through the body)