Bowel

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 nutrients from the food are absorbed. The remaining waste moves through the colon to the rectum and is expelled from the body. The colon retains the waste until it is ready to be expelled.

Diseases of Colon:

Surgery can be recommended for different benign and malignant colonic disorders. The most common include diverticulitis, colonic polyps and colon cancer. Diverticulitis is a condition which may be caused by too many years of not enough fiber (roughage) in the diet making the colon squeeze very hard and form pockets. While most patients with diverticulosis (up to 60% of people by age 70) have no symptoms, each of these pockets can act like an appendix and can get infected, or even rupture. Sometimes bleeding can occur. There is no clear explanation about the reason for occurrence of colonic polyps - genetic factor seems to have large influence. Certain types of colonic polyps can be characterised as a “precancerous” conditions. The larger the polyps, the greater the chance of developing cancer.

Most patients faced with colon surgery are concerned over whether they will have to wear "a bag" (colostomy) into which their bowel empties. This is unusual in colon cancer cases unless the cancer is so low in the rectum that once removed, there is no bowel to hook it back together. Colostomies are not unusual in emergency diverticulitis surgery as the bowel is so infected that joining it together immediately may not be safe. It may leak, requiring yet another operation. They are, however, usually temporary in this setting, and the patient can be brought back in for surgery to restore their usual bowel function in a few months. For this reason, however, when the patient is faced with repeated infections, a recommendation may be made for "elective" colon surgery as it can usually be completed in one stage without a colostomy.

We advocate a technique known as minimally invasive or laparoscopic colon surgery which allows us to perform many common colon procedures through small, tiny incisions. Depending on the type of procedure, patients may leave the hospital in a few days and return to normal activities more quickly than patients recovering from open surgery. The rectum and colon must be completely empty before surgery. Usually, the patient should drink a special cleansing solution. We operate through 4 or 5 small incisions (each about a quarter inch) while watching an enlarged image of the patient's internal organs on a television monitor. Abdomen is distended with carbon dioxide, laparoscope and other long instruments inserted. The bowel is separated from the attachments and after removal of the diseased part anastomosis is performed to maintain intestinal integrity. In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure.

Using the laparoscopic approach we perform: Right Hemicolectomy, Left Hemicolectomy, Sigmoidectomy, Anterior Resection of Rectum, Abdominal Perineal Resection, Subtotal or Total Colectomy.

Laporoscopic colon surgery bears many advantages, some of which are: less postoperative pain, possibly a shorter hospital stay, faster return to solid-food diet, quicker return of bowel function, quicker return to normal activity, and improved cosmetic results.

After the operation, it is important to follow the doctor's instructions. Many people feel better in a few days, nevertheless, the body needs time to heal. Try to be out of bed the day after surgery and to walk. This will help diminish the soreness in muscles. It will likely be possible to continue most normal activities after one or two weeks. These activities include showering, driving, walking up stairs, working and engaging in sexual intercourse.

Certain uncommon complications may occur. These include bleeding, an infection, a leak where the colon was connected back together, injury to adjacent organs such as the small intestine, ureter, or bladder, and blood clots to the lungs.

It is very important to recognize the early signs of possible complication. They can be:

persistent fever over 39°C, bleeding from the rectum, increasing abdominal swelling, pain that is not relieved by medications, persistent nausea or vomiting, chills, persistent cough or shortness of breath, purulent drainage (pus) from any incision, redness surrounding any incisions that is worsening or getting bigger, or an inability to eat or drink liquids.

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