Large Bowel Resection

What is colon?

The colon, which is another name for the large intestine, is an important part of the digestive system. The intestine is a long, tubular organ consisting of the small intestine, the bowel and the rectum.

Foods start to digest in the stomach. Nutrients and water that have been removed from the digested food pass through the walls of the small intestine. The unabsorbed and undigested food that remains then moves to the large intestine. Here, some more nutrients and water are absorbed. The remainder is stored in the rectum until it leaves the body through anüs.

What is Laparoscopic Colon Resection?
With the technique known as minimally invasive laparoscopic colon surgery, the surgeon can perform many colon procedures with small incisions. Depending on the type of procedure, patients may be discharged from the hospital within a few days and return to normal activities more quickly than those who have undergone open surgery.

In most laparoscopic colon resections, surgeons operate through 4 or 5 small openings while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings can be extended to 5-10 cm in size to complete the procedure.

Most colonic diseases are diagnosed by one of two tests: Colonoscopy and colonography.

A colonoscope is a soft, bendable and index finger-thick tube that is inserted through the anus and pushed to the end of the large intestine. Colonography is an x-ray taken when a white liquid called barium enema is squeezed into the rectum and excreted through the entire large intestine by applying light pressure. With these tests, the surgeon can see the inside of the colon. Sometimes computed tomography may be required for intra-abdominal. Blood tests, ECG or lung x-ray may be ordered before surgery.

 

Preparations for surgery

  • After your surgeon has reviewed the benefits and harms of the operation with you, he or she will ask you to inform you in writing of your consent.
  • Depending on your situation, blood transfusion and /or other blood products may be required.
  • It is recommended that you take a shower on the night or morning before surgery.
  • The rectum and colon should be completely empty before surgery. Generally, the patient drinks a special cleaning fluid solution. Liquid foods, laxatives and enemas can be taken for several days before surgery.
  • Oral antibiotics are usually prescribed. Your surgeon will give you the instructions.
  • Follow your surgeon’s instructions strictly. Report the situation if you are unable to complete the preparations or take antibiotics.
  • If you do not complete the preparations, surgery may have unsafe consequences and may require reassessment.
  • After midnight before surgery, you should not eat or drink anything. You can only take medicines that the surgeon tells you to take with less water on the morning of surgery.
  • Blood thinning drugs, anti-inflammatory drugs and vitamin E intake should be stopped temporarily one week before surgery.
  • Two weeks before surgery, diet medications should be discontinued.
  • Stop smoking and make arrangements at home.

 

How is laparoscopic colon resection performed?

Laparoscopic surgery is the technique used by surgeons to o gain access to the abdominal cavity. Most laparoscopic colon procedures begin in the same way. Using a cannula (a narrow tube instrument) is entered into the abdominal area. The laparoscope (a small telescope connected to the video camera) is inserted into the cannula so that the surgeon can see the patient’s internal organs in an enlarged size from the television monitor. A few more cannulas are used to allow the surgeon to work inside and remove part of the colon. All surgery can be completed through cannulae or by extending one of the small cannula incisions.

 

What are the advantages of laparoscopic colon resection?

  • Less postoperative pain
  • Shorten hospital stay
  • Rapid transition to solid-food diet
  • Faster return to normal bowel functions
  • Faster return to daily routine
  • Better cosmetic results

Although laparoscopic colon resection has many benefits, this method is not suitable for all patients. Consult your physician to see if the technique is right for you and get a detailed evaluation from a surgeon qualified in laparoscopic colon resection.

 

What happens if the operation cannot be completed by laparoscopic method?

In some patients, laparoscopic method may not be applied. Factors that may increase the likelihood of opting for ‘open’ surgery or returning to an open method during the procedure are:

  • Obesity
  • A history of prior abdominal surgery causing dense scar tissue
  • Unable to see organs
  • Bleeding problems during surgery
  • Large tumors

The decision to perform open surgery is a decision of the surgeon before or during the operation. This decision is based on the safety of the patient.

 

What to expect after surgery?

It is very important to follow the instructions given by the doctor after surgery. Many people feel well within a few days, but remember that the body needs time to heal. On the first postoperative day, you are told to get out of bed and walk.

You will return to most of your routine activities in 1-2 weeks. You should ask your doctor for a follow-up appointment two weeks after surgery.

 

What complications may occur?

  • Bleeding
  • Infection
  • Infiltration where the column is reconnected
  • Damage to nearby organs such as small intestine, ureter or bladder
  • Blood clots in the lungs

 

When to call your doctor?

  • Continuous fever above 39 degrees
  • Bleeding in the rectum
  • Increased abdominal swelling
  • Pain that cannot be relieved by drugs
  • Persistent nausea or vomiting
  • Shaking
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