National Mentor for Colorectal Surgery
The Colon and the Rectum are the last parts of the large intestine. Cancer starting in these parts are known as colorectal cancer. For this treatment, the affected part should be removed surgically. This type of cancer mostly affects only the colon. So colectomy is frequently performed for this condition.
Whenever there is a growth or tumor in the intestine, its not a good thing. It should be removed as soon as possible. And the way by which it is to be removed is colectomy.
Colectomy is performed to remove the segment of the colon which is diseased because of various conditions, most commonly, cancer of the colon. Other conditions that may require removal of the colon include diverticulosis which bleeds and tuberculosis of the intestine which causes obstruction because of fibrosis of the wall of intestine. The colon is also removed because of some nonspecific ulcers in the intestine. The standard laparoscopic surgery is done via four holes made in the abdomen. It can also be done through one hole, and in both cases the procedure leaves no scars.
How is Colectomy Performed?
The part of the colon that contains the tumor is cut off and the affected portion is removed.
The two free ends are then rejoined.
A part of unaffected portion of the large intestine will then be attached to an opening made in the abdomen, through which a bag will be connected. This step is called the colostomy procedure.
The colostomy bag collects fecal material directly from the large intestine.
- Right Hemi-colectomy :- This process involves the removal of right sided colon defect. Procedure takes about 1 hour.
- Left Hemi-colectomy:- This process involves the removal of left sided colon defect. Procedure takes about 2 hours.
- Total Abdominal Colectomy:- This results in the complete removal of the colon. Procedure takes about 2 hours 30 minutes to 3 hours
- Sigmoidectomy:- This process involves removal of sigmoid colon. Procedure takes about 1 hour.
Cancer is, as everyone knows, very dangerous if it spreads to other tissues. So before it progresses, early treatment is recommended.
Life after Laparoscopic Colectomy
Since most of the absorption of nutrients take place in the small intestine, the large intestine or colon is mainly involved only in absorption of water and transmit the undigested food material out of the body. So removing the affected large intestines does no harm to the body. However since water absorption is less, one should drink enough amount of water following surgery.
Moreover, a bag will be connected to collect the faeces. Proper care should be taken, by keeping it clean and hygienic. Bag should be emptied on a regular interval.
VIDeo: laparoscopic right hemicoloectomy
No. Once tumor is made in the colon, the best way forward is to have it removed and this is called the colectomy. Chemotherapy and radiation might be of some accessory help, but your primary treatment route is colectomy.
No. The keyhole option is quite an excellent alternative, and something that we have been doing for the last fifteen years. Although technically difficult a laparoscopic ( keyhole ) colectomy is very good and comfortable for patients, with very little blood loss or pain.
Unfortunately only for keyhole colectomy, although you will have very little pain we can not send u back in a day are two, but five days is a reasonable estimate, Come back to a open colectomy where you will have to stay for 7 to 10 days. What’s most important is that you will be completely normal, on your feet, and ambulant in those five days. So as for as freedom from pain and discomfort are concerned ,this is the best alternative.
Laparoscopic colectomy carries lesser side effects than open colectomy. But if the cancer has extended down to the rectum, then laparoscopic colorectal surgery carries one or two side effects like alteration in sexual function. But as far as colectomy is concerned this does not seem to create problem .
Although open colectomies, traditionally, were often accompanied by lots of blood loss, in laparoscopic or keyhole colectomy we tend to coagulate the tissues and stop the bleeding before we cut them. This prevents unnecessary loss of blood during the procedure, and very rarely do we actually need to give blood to a colectomy patients. Certainly, at LIMA, for the last five years, we are not giving blood to any patient undergoing laparoscopic colectomy.
No, we will not require a bag for any laparoscopic colectomy. It is an unfortunate addition when we perform laparoscopic surgery for cancer of the rectum, but that too in more than 95% of patients it is only a temporary measure. After 6 weeks the bag is taken out and the colon is put back inside. Please remember, this is for patient with rectal cancer. All colectomies, after resection ( removal) of the bad segment of the gut, are followed by anastamosis ( joining together of the two ends of the gut, to prevent the need for a bag. )
Lap Colectomy specialists
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.)
Dr. R. Prabhakaran
Consultant Surgical Gastroenterology
M.B.B.S., M.S. (GENERAL SURGERY), M.Ch. (SGE), DLAP, FACRASI
Dr. S. Akbar
Consultant General and Laparoscopic Surgery
M.B.B.S., M.S (GENERAL SURGERY), D.MAS, F.MAS.