COLON RESECTION SURGERY

Summary

The colon is the large intestine; it is the lower part of your digestive tract. The intestine is a long, tubular organ consisting of the small intestine, the colon (large intestine) and the rectum, which is the last part of the colon. After food is swallowed, it begins to be digested in the stomach and then empties into the small intestine, where the nutritional part of the food is absorbed. The remaining waste moves through the colon to the rectum and is expelled from the body. The colon and rectum absorb water and hold the waste until you are ready to expel it.

Colon resection surgery is done to remove all or part of the colon. Colon resection or colectomy is usually needed to treat colon cancer, but may also be done to treat bowel diseases such as diverticulitis, blockages or severe bleeding. During this surgery part of the colon is removed and the ends are reattached. If there isn’t enough healthy large intestine left to reconnect, a stoma may be created for a colostomy.

Reasons for colon resection surgery

Types

1Laparoscopic colon resection
Although surgery is not always a cure, it is often the best way to stop the spread of disease and alleviate pain and discomfort. A technique known as minimally invasive laparoscopic colon surgery allows surgeons to perform many common colon procedures through small incisions. Depending on the type of procedure, patients may leave the hospital in a few days and return to normal activities more quickly than patients recovering from open surgery.

In most laparoscopic colon resections, surgeons operate through 4 or 5 small openings made in the lower abdomen. Through these small openings, a thin tube-like tool known as a laparoscope can be inserted. This tool is fitted with a camera to allow your surgeon a magnified view of the patient's bowels without the need for large invasive incisions. Through other small openings, more thin tools can be inserted and used to resect and remove part of the colon as needed.

In some cases where laparoscopic surgery isn’t possible, the surgery may need to be done through larger incisions.
2Traditional open colon resection
The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

While this surgery is deemed more invasive, the procedure remains the same. Through a larger incision made into the abdomen, the muscle and tissue are moved aside to gain access to the colon. Part of the colon is then removed, the ends of the colon are reattached to one another, and the incision is closed.

This open surgery technique results in an average hospital stay of a week or more and usually 6 weeks of recovery.

Preparing for surgery:

Most diseases of the colon are diagnosed with one of two tests: a colonoscopy or barium enema.

  • A colonoscope is a soft, bendable tube about the thickness of the index finger, which is inserted into the anus and then advanced through the entire large intestine.
  • A barium enema is an X-ray where a white "milk-shake fluid" is flushed into the rectum and by using mild pressure is pushed throughout the entire large intestine.

These tests allow the surgeon to look inside 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.

After your surgeon reviews the potential risks and benefits of the operation with you, you will need to provide written consent for surgery.

Blood transfusion and/or blood products may be needed depending on your condition.

It is recommended that you shower the night before or the morning of the operation.

The rectum and colon must be completely empty before surgery. Usually, the patient must drink a special cleansing solution. You may be on several days of clear liquids, laxatives and enemas prior to the operation.

Antibiotics by mouth are commonly 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 surgery, and it may have to be rescheduled.

After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water

Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.

Diet medication or St. John's Wort should not be used for the two weeks prior to surgery.

Quit smoking and arrange for any help you may need at home.

Recovery:

After the operation, it is important to follow your doctor's instructions. Although many people feel better in a few days, remember that your body needs time to heal.

You are encouraged to be out of 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 upstairs, working and engaging in sexual intercourse.

Call and schedule a follow-up appointment within 2 weeks after your operation.

Risks:

It is important for you to recognize the early signs of possible complications. The complications that may occur with this surgery include:

  • Bleeding
  • Infection
  • A leak where the colon was connected back together
  • Injury to adjacent organs such as the small intestine, ureter, or bladder
  • Blood clots to the lungs
  • Contact your surgeon if you notice severe abdominal pain, fevers, chills, redness surrounding any of your incisions that is worsening or getting bigger, or rectal bleeding.

Hospital

Operating from the new state-of-the-art, multi-disciplinary facility equipped with only the most advanced medical technology,

Equipment

As one of only two such robots in the Western Cape, Dr Kavin operates from a hospital boasting Robotic Surgery capabilities,

Technique

As a surgeon with adept skill in minimally invasive techniques, Dr Kavin opts for laparoscopic keyhole surgery whenever possible.

Expertise

Dr Bruce Kavin is a General Surgeon with particular expertise in Endocrine, Colorectal and Gastrointestinal Surgery and Surgical Oncology.

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