Colon surgery is a procedure that is recommended for patients with certain medical conditions like diverticulitis, inflammatory disease, or colon cancer. The procedure is done to remove the portion of the intestines that is diseased or damaged. In patients who require colon surgery for cancer, the procedure is referred to as a colostomy.
A colostomy is a surgical procedure in which a portion of the large intestine or colon is sectioned off and redirected to an exterior opening in the abdominal cavity. The opening in the abdominal wall is made by the surgeon to bypass the diseased or damaged portion of the intestines.
If you or a loved one has been recommended for colon surgery, read this to learn what to expect before, during and after the procedure at Orange County Robotic General Surgery.
- Why would I need colon surgery or a “colectomy?”
- How to prepare for colon surgery?
- Open surgery vs. laparoscopic
- How long is colon surgery?
- What happens during the surgery?
- Does the entire colon need to be removed?
- Are there any surgical risks?
- How long does recovery take?
Why Would I Need Colon Surgery or a “Colectomy?”
Colon surgery treats a variety of conditions, including cancers or diseases of the bowels that are unresponsive to medication. Surgery removes the affected portion of the intestines to allow the rest of the digestive tract to heal and resume normal function. Below are some of the common conditions colon surgery or a colectomy treat.
Inflammatory bowel disease – Long-term inflammation can cause bleeding and issues like ulcerative colitis, Crohn’s disease, and other inflammatory bowel ailments with severe symptoms. Without surgery, these conditions can become life-threatening.
Diverticulitis doesn’t always respond to antibiotics or medication. Symptoms that recur or become severe can cause damage to other organs in the abdominal cavity. Surgery is necessary to remove the diseased portion of the intestines for preventive measures.
Bowel obstructions are common and can become dangerous if initial treatments and medications don’t work. Surgery is reserved for advanced cases where the removal of the twisted, narrow, or blocked portion is necessary.
Precancerous conditions are often identified with a colonoscopy, although other medical tests may be used for diagnosis. If the tests reveal abnormal changes in the colon or intestines that are potentially cancerous, surgery is often prescribed as a preventive measure. Colon surgery is also offered as an elective procedure for individuals with a family history of certain risk factors, such as familial adenomatous polyposis (FAP) or Lynch syndrome.
Colon cancer often requires surgery so doctors can remove the infected portion of the colon to biopsy the cells and determine the stage of cancer present and suitable treatment plan for patients.
How to Prepare for Colon Surgery?
Prep for colon surgery is a bit different than other surgical procedures. To start, patients must undergo a health screening to ensure they are fit for the operation. Besides having a complete medical history review and physical, additional diagnostics are necessary. Blood work, EKGs, urinalysis, x-rays, and a colonoscopy are used to prepare patients for colon surgery.
A colonoscopy is a diagnostic procedure in which a physician utilizes a special surgical scope with a light and camera attached to visually inspect the tissues of colon and rectum.
Preoperative counseling is also required before colon surgery scheduling. Counseling provides patients with in-depth information about their procedure, such as the benefits for their situation, how to prepare their bodies, how the procedure is performed, what to expect during recovery and outcome.
Patients also learn of the risks, if they will need a colostomy, pain management options, and bowel prep. Consent is also required at the end of the preoperative counseling visit so they can schedule their surgery. Patients should be prepared to discuss any and all related concerns during their pre surgery counseling visit and at any time afterward.
Patients should also inform surgeon of any current medication and herbal supplements they use to learn if they should stop taking them before the procedure. In most cases, it is necessary to temporarily cease medicinal therapies until the surgeon provides medical clearance to resume.
Bowel preparation also involves patients having to consume a clear diet to help clear their bowels and prevent stress to their gastrointestinal tract. Patients are also required to do the following for bowel preparation for colon surgery.
- Dietary changes are necessary and should be made a few days ahead of time. Clear fluids and light-colored broths are recommended.
- 12 hours before and on the day of surgery, patients must refrain from eating or drinking anything, including even water.
- It’s important for patients to clean their bowels 24 to 48 hours before their operation. An enema or laxative is provided for patients to use at home to help flush their colon.
For a successful surgery, the bowels must be free and clear of foods and fluids that could interfere with the outcome of the operation. Patients should follow all preoperative instructions.
Open Surgery vs. Laparoscopic
Colon surgery is done in two ways: laparoscopic and open.
Open surgery involves the surgeon making a large incision across the patient’s abdomen so the surgeon can access the surgical field and make the necessary revisions to the colon.
Laparoscopic colectomy requires small incisions on the abdomen so the surgeon can insert a tiny camera and his laparoscopic surgical instruments to complete the procedure. Laparoscopic colectomy patients have less pain, fewer postoperative limitations, and quicker recoveries.
How Long Is Colon Surgery?
In most cases, colorectal surgery takes anywhere from two to three hours to complete. However, some procedures can take up to six hours or longer, depending on the condition treated.
What Happens During the Colon Surgery?
Before the procedure starts, patients receive general anesthesia to relax and put them to sleep. Once properly sedated, the surgeon performs either an open or traditional surgery or a laparoscopic one. For open surgery, a large incision is made on the stomach so the surgeon can operate. Laparoscopic-assisted patients have their procedures performed via several much smaller incisions.
During surgery, the surgeon removes the comprised section of the intestines and either attaches the two remaining ends of the colon together or creates an opening in the patient’s abdominal wall for a stoma. A stoma is an opening in the stomach that connects the bowels. Stomas are typically provided to patients who have significant large intestine damage that requires bypass to have normal bowel movements.
For patients with precancerous or cancer related issues, the nearby lymph nodes may be removed as well. Once the work is complete, the surgeon sutures the incisions closed and sends the patient for post-operative monitoring.
Does the Entire Colon Need to Be Removed?
With colon surgery, the entire appendage doesn’t have to be removed, just the portions that are diseased or damaged. Some patients only require a small portion of their colon or intestines to be removed to treat their conditions; others benefit from complete removal. Below are the names of the different types of colon surgery according to the section that’s targeted for removal.
Partial or subtotal colectomy refers to colon surgery that removes a part of the colon.
Total colectomy involves the entire removal of the colon which includes a significant portion of the large intestine.
Sigmoid colectomy, also referred to as a sigmoidectomy, involves the removal of the end of the colon (sigmoid). This is the section of the colon that attaches to the rectum.
Hemicolectomy involves the removal of one side of the intestines. The colon has an ascending (right) side located in the upper portion and a descending (left) side located in the lower portion. Left side hemicolectomy is the removal of the descending portion; right side hemicolectomy is the removal of the right.
Proctocolectomy is the partial or complete removal of the colon and rectum. When the entire rectum and colon are removed, the procedure is called a total proctocolectomy.
Are There Any Surgical Risks?
As with any type of surgery, there are complication risks patients should be aware of beforehand. Complication risks are low, but include the following:
- Intestinal bleeding
- Incisions reopening
- Intestinal scar tissue that causes narrowing or blockage/stricture
- Injury to nearby organs
- Nerve damage
- Bowel irregularities
- Bladder dysfunction
- Anastomotic leak or defect in the intestinal wall
How Long Does Recovery Take?
Colon surgery recovery generally takes six weeks. However, most patients feel well and healed enough to resume many of their normal routines within two weeks after surgery. Patients should follow all post-operative instructions and attend all follow-up care appointments to avoid complications, healing impairments, and ensure an optimal outcome.
Colon surgery is a safe and effective treatment for colon and intestinal disorders that are untreatable with medication or severe enough to be life threatening. Colon surgery is also a standard treatment for colon cancer.
The type of surgery performed depends on the patient’s health, diagnosis, portion of the bowels compromised, and surgeon’s recommendations. Recovery is manageable and remarkably swift and uneventful for patients who follow their treatment protocols as directed.
To find out if inguinal hernia repair surgery is right for you, Contact Orange County General Robotic Surgery at (714) 706-1257 for a consultation with Dr. Abtin H. Khosravi.