Colon and Rectal Surgery

Tens of thousands of surgeries for large intestine diseases are performed every year in Turkey. We perform colon and rectum surgery for the treatment of diseases such as cancer, polyp, inflammatory bowel diseases (Crohn and ulcerative colitis), colon stenosis, and diverticulitis.

What is Colon?

Colon is the last part of the digestive system in other words, it is the large intestine. The end of colon is called “rectum”. Total length of the colon is average 1,5 meter. Nutrients we eat are absorbed in the small intestine and residuals reach to the colon.  Fluid of these residuals is absorbed in colon and rectum and wastes are stored in the rectum.

What is the laparoscopic colorectal surgery?

Laparoscopic colorectal surgery is the large intestine surgery performed with specialized instruments and camera through the small ports without large incisions on the abdominal skin. It is known as the “closed surgery” by the public. A number of colorectal surgeries including cancer surgery can be performed by accessing through 4-5 small ports by means of the laparoscopy. The patients stay in hospital for shorter time than the open operations, they feel less pain and get better in a shorter time.

Advantages of laparoscopic colorectal surgery

  • Less postoperative pain
  • Shorter time of hospitalization
  • Solid food diet is initiated sooner
  • Intestine functions get better faster.
  • Quicker return to the normal life.
  • Fewer scars.

Am I eligible for the laparoscopic surgery?

Intra-abdominal surgical procedure carried out in the closed large intestine surgery is the same as the open surgery. The only difference is that this procedure is performed without a large incision. This is the reason of all mentioned advantages.

However, this special technique cannot be applied to all patients. Sometimes open surgery may be necessary although the operation has been initiated with the closed method. Every patient should be examined and evaluated in detail.

What is done in the pre-op preparation?

Diagnosis of colon and rectal diseases is generally established by the colonoscopy and if necessary biopsy (sample) is taken. At the next stage, computerized tomography or MR is applied if necessary. Blood analysis, lung graphy, EKG are performed prior to the operation and then consultations are performed.  Sometimes blood can be prepared. The patient is included in the operation program after the operation preparation is completed.

It is recommended that you should have a bath one night prior to the operation. Purgation may be carried out at the option of the physician and by the site of the disease. For this reason, you may use lapactic medicine and consume liquid food a few days before the operation.

You should not eat and drink anything as of the night before the operation. Your stomach should be empty for minimum 6-8 hours before the anaesthesia procedure is performed. You should not smoke on the day of operation and in the recovery period. You should inform the physicians if you need to take medicine in the morning. If you use blood thinner such as aspirin or vitamin E, you should stop your medicines under the control of physician.

How is the laparoscopic colorectal surgery carried out?

Intra-abdominal region is viewed by accessing by a camera through the canal inserted from the umbilicus. Other canals are placed in the site of the operation. Specialized instruments are used for the operation. The part is removed by enlarging the proper opening. Intestines are joined and the surgery ends.

What happens if the surgery is not performed with the laparoscopic method?

Some patients cannot have laparoscopic (closed) surgery. Open method can be used or laparoscopic method can be used at the beginning and then open method is used. This possibility increases in the below conditions:

  • Obesity
  • Adhesions due to previous operations
  • Not imaging the organs
  • Bleeding problem during the surgery
  • Big tumours

The decision of performing the surgery by the open methods is made by the physician before or during the surgery. If the surgeon decides that shifting from laparoscopic method to the open methods is the safest option, it is not a complication, it is a very sound surgical decision. Decision of applying an open procedure is based on the patient’s safety.

Post-operative process

You should follow the instructions of your physician following the operation. Although many people recover within a few days and feel themselves better, don’t forget that you need some time for recovery.

You will be encouraged to stand up and begin the respiratory exercises about 4 hours after you are taken to your room. You will be able to do most of your normal activities within 1-2 weeks. Your follow-up will begin about 2 weeks later with the control appointment.

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Obesity and Metabolic Surgery

Surgeon MD Özgün Akgül