Laparoscopic - Colon-Rectum Surgery

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Know about Colon Introduction

Know about Colon Introduction

Know about Colon Introduction

Know about Colon Introduction

Know about Colon Introduction

The colon is the large intestine; it is the lower part of 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.



Diagnosis

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 a special 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 of the colon. In case of malignancy, CT scan of abdomen is required to know about local spread of disease.



Indications

Although laparoscopic colon resection has many benefits, it may not be appropriate for some patients. Colon stricture due to tuberculosis, Crohns disease and early stage cancer of colon are usually treated with laparoscopic surgery. Our health care team with discuss with you in detail and you are encourage for active discussion regarding appropriate procedure for you.



Know about Colon Surgery (Coloectomy)

Laparoscopic Colon Surgery

Laparoscopic colon surgery is performed through small incisions for various indications.

Laparoscopic Colon Surgery

Laparoscopic Colon Surgery


A cannula (hollow tube) is placed into the abdomen and your abdomen will be inflated with carbon dioxide gas to create a space to operate. A laparoscope (a tiny telescope connected to a video camera) is put through one of the cannulas which projects a video picture of the internal organs and spleen on a television monitor. Several cannulas are placed in different locations on your abdomen to allow your surgeon to place instruments inside your belly to work and remove your colon. After the colon is cut from all that it is connected to, it is placed inside a special bag. The bag with the colon inside is pulled up into one of the small, but largest incisions on your abdomen and colon within the special bag is removed for body.

Common advantages of laparoscopic colon surgery are: Less postoperative pain, shorten hospital stay, quicker return to bowel function, quicker return to normal activity & better cosmetic results.



Preparation for Surgery

Our expert team members shall help you to prepare you for surgery.

Pre-operative testing

In most cases, you will need some tests before your surgery. The tests routinely used include:

  1. Blood tests to measure your blood counts, your risk of bleeding or infection, how well your liver and kidneys are working and blood grouping, in case you need blood transfusion.
  2. Chest x-ray and ECG (electrocardiogram) to check your lungs and your heart’s electrical system.

Anaesthetic Assessment before Surgery:

Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailments, allergic reactions you’ve had in the past and current medicines that you are taking like blood thinning medicine. This medicine should be stopped prior to surgery to minimize the risk of bleeding during /after surgery.

Informed Consent

Informed consent is one of the most important parts of “getting ready for surgery”. It is a process during which you are told about all aspects of the treatment before you give your doctor written permission to do the surgery.

Getting ready for Surgery

Depending on the type of operation you have, there may be things you need to do to be ready for surgery:

  1. Emptying your stomach and bowels (digestive tract) is important. Vomiting while under anaesthesia can be very dangerous because the vomit could get into your lungs and cause an infection. Because of this, you will be asked to not eat or drink anything starting the night before the surgery.
  2. Laxative: You may also be asked to use a laxative or an enema to make sure your bowels are empty.
  3. Shaving of Operative part: You need to have an area of your body shaved to keep hair from getting into the surgical cut (incision). The area will be cleaned before the operation to reduce the risk of infection.

Anaesthesia

Anaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anaesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal tube (ET tube) is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anaesthesia often feel “out of it” for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.



Recovery from Surgery

Pain

You may feel pain at the site of surgery. We aim to keep you pain free after surgery with the help of latest and most effective analgesic (pain relieving medicine).

Eating and Drinking

You will be allowed orally liquids once you recover from effect of anaesthesia medicine and you don’t have nausea or vomiting. Gradually you can add soft to normal diet.

Activity

Our health care team will try to have you move around as soon as possible after surgery. You are encouraged to get out of bed and walk the same day. While this may be hard at first, it helps speed your recovery. It also helps your circulation and helps prevent blood clots from forming in your legs.

Going home

Once you are eating and walking, and then you are ready to go home, in most case in next day following surgery. Before leaving for home our health care team shall give you detailed guidance regarding diet, activities, medications & further plan of treatment



Risks and side effects of surgery

There are risks that go with any type of medical procedure and surgery is no longer an exception. Success of surgery depends upon 3 factors: type of disease/surgery, experience of surgeon and overall health of patients. What’s important is whether the expected benefits outweigh the possible risks.

Complications in major surgical procedures include:

Complications related to Anaesthesia: Reactions to drugs used (anesthesia) or other medicines. Although rare, these can be serious because they can cause dangerously low blood pressures.

Complications related to underlying medical illness like heart disease, diabetes, kidney disease, obesity, malnutrition.

Complications related to Specific Operations:

  1. A leak at the new joint of colon.
  2. Intestinal obstruction
  3. Injury to adjacent organs such as the small intestine/duodenum, ureter.
  4. Bleeding, infection etc
  5. You are encouraged with discuss in detail with our health care team before you give your consent for surgery.

Conversion to open surgery: In a small number of patients the laparoscopic method is not feasible because of the inability to visualize or handle the organs (appendix) effectively. Factors that may increase the possibility of converting to the “open” procedure may include perforated & densely adherent appendix to nearby organ, obesity, a history of prior abdominal surgery causing dense scar tissue, or bleeding problems during the operation. The decision to convert to an open procedure is strictly based on patient safety.

Side effect of Surgery: Few people may develop more frequent bowel movement but over a time it improves to normal bowel movements. Remaining colon usually acquire the function without affecting overall health of person.



Operative Photos

Operative Photos





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Life After Surgery

Nutrition

Our health care team shall advise you in detail regarding dietary habits, Briefly, your diet begins with liquids followed by gradual advance to solid foods.

Exercise

Patients are encouraged to engage in light activity while at home after surgery. You will be able to get back to your normal activities within a short amount of time (week).

Follow up

You may be advised to see our health care team after 1 week to assess your progress and to address your problems.

 
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