Laparoscopic Colorectal Surgery

What is the Colon?

The colon, also known as the large intestine, is a crucial part of the digestive system. It is the lower section of the digestive tract and follows the small intestine. After food is digested in the stomach, it passes through the small intestine, where nutrients are absorbed. The leftover waste is then transported to the colon, where water is absorbed, and the waste is stored until it is ready to be expelled from the body through the rectum.

Colorectal conditions that can be treated laparoscopically

• Diverticular disease
• Appendicitis
• Large colon and rectal tumours or polyps
• Rectal prolapse (when rectal tissue relaxes or is no longer supported by the surrounding muscle)
• Colon volvulus (twisting or displacement of the intestines causing obstruction)
• Inflammatory bowel disease (IBD—Crohn’s or ulcerative colitis)

What is Laparoscopic Colon Resection?

Laparoscopic colon resection is a minimally invasive surgical technique used to treat conditions affecting the colon. Unlike traditional open surgery, this method uses small incisions, allowing surgeons to operate with the help of a camera (laparoscope) and specialized tools. Typically, the procedure is performed through 4 or 5 small incisions, each about a quarter inch, providing surgeons a magnified view of the internal organs via a monitor. In some cases, one of the small incisions may be lengthened slightly to complete the surgery.

Advantages of Laparoscopic Colon Resection

The benefits of laparoscopic colon resection include:

• Reduced postoperative pain
• Shorter hospital stays
• Quicker return to a regular diet
• Faster recovery of bowel function
• Faster return to daily activities
• Improved cosmetic results due to smaller scars

Are You a Candidate for Laparoscopic Colon Resection?

While laparoscopic colon resection has several benefits, it may not be suitable for all patients. Consult with Dr. Mohit Agrawal, an expert in laparoscopic surgery, along with your primary care physician to determine if you are a good candidate for this minimally invasive procedure.

Preparing for the Surgery

Preoperative Tests:

Common diagnostic tests for colon conditions include a colonoscopy or a barium enema. A colonoscopy involves using a flexible tube to examine the entire large intestine, while a barium enema involves an X-ray after a special liquid is inserted into the rectum. Additional tests, such as a CT scan, may also be necessary.

Preoperative Preparation:

• Blood work, chest X-ray, and an EKG (if necessary)
• Discussion of risks and benefits with your surgeon
• Consent for surgery
• Blood transfusion may be required in rare cases
• Bowel cleansing with a special solution
• Antibiotics may be prescribed
• Follow your surgeon’s instructions closely regarding fasting and medications.

How is Laparoscopic Colon Resection Performed?

Laparoscopic surgery involves the use of a small camera (laparoscope) inserted into the abdomen through a narrow tube. The abdomen is inflated with gas to give the surgeon more space to operate. The surgeon views the internal organs on a monitor and uses small instruments to remove the affected section of the colon. In some cases, one incision may be slightly enlarged to assist in completing the procedure.

What if the Surgery Cannot be Completed Laparoscopically?

In certain cases, the laparoscopic procedure may need to be converted to open surgery. Factors that may lead to this decision include:

• Obesity
• Prior abdominal surgeries causing scar tissue
• Bleeding complications
• Large tumors
• Difficulty in visualizing organs

Switching to open surgery is a decision based on patient safety and is not considered a complication.

What to Expect After Surgery

After the procedure, it’s important to follow your doctor’s recovery plan:

• Be out of bed and walking the day after surgery to reduce muscle soreness.
• Most normal activities can be resumed within 1 to 2 weeks, including showering, driving, and working.
• Schedule a follow-up appointment within two weeks.

Possible Complications

Although rare, complications from laparoscopic colon resection may include:

• Bleeding
• Infection
• Leakage where the colon was reconnected
• Injury to nearby organs like the small intestine or bladder
• Blood clots in the legs