2-3 hr : 00 min
Cancer starting in the rectum are called as rectal cancer. Sometimes a collection of abnormal cells called polyps form on the inner walls of the large intestine. Mostly they are not harmful. But sometimes they can develop into a cancer. Most rectal cancers originate from small, noncancerous tumors.
Understanding ABDOMINO PERINEAL RESECTION
An abdominoperineal resection is a surgery in which the anus, rectum, and sigmoid colon are removed. This can be done via open or laparoscopic surgery. Hospital stays after a laparoscopic abdominoperineal resection average from 5 to 7 days. A pouch is fitted over the abdomen immediately after surgery to be a temporary substituent for the removed sections. It takes few days for the digestive system to become active again. This is signaled by the passage of gas and then stool through the stoma (pouch). Diet is slowly increased from sips of water to full liquids then progressed to solid foods as your intestines start functioning.
How is ABDOMINO PERINEAL RESECTION Performed
After the ports are created, laparoscope and other specialized surgical instruments are inserted. The organs within the abdominal cavity is visualized, with the help of a video monitor that displays live pictures of the interior of the abdomen.
The main blood vessels of the bowel(intestine) are carefully cut and bleeding is controlled using heat. The anus, the rectum and part of the sigmoid colon(intestine) is separated from the rest of the intestines and removed. Since lymph nodes are responsible for the spread of cancer, the involved lymph nodes are also removed along with it.
A part of skin will be removed from the first incision site. The open end of the cut colon will be pulled through this opening, to the surface of the skin. This known as “end colostomy”. “colo- intestine, stomy- opening”.
The abdominal cavity will then be rinsed thoroughly and a small drainage tube will be inserted into one of the incision sites(lower mainly). Finally, after careful inspection of the abdominal cavity, the incisions are sutured. These sutures will be removed after a week or so after complete healing.
After the surgery, the patient will be fitted with a bag attached to the opening created in the abdomen. The bowels contents (faeces) are emptied into this bag. This bag and the created opening needs regular cleaning and care, to avoid infections. Before discharge home, the doctors and nurse will teach how this is to be done.
Video: ABDOMINO PERINEAL RESECTION
Dr. J.S Rajkumar
M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)