Colorectal Surgery

Colorectal surgery deals with disorders of the rectum, anus, and colon. It is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular. It involves removing the cancer and some of the wall of the rectum. Your doctor may do it through the anus (the opening of the rectum) or through a small cut in the rectum. The procedure does not require major surgery.

When is a colorectal surgery needed?

One may need a colorectal surgery in case of:

• Diverticular disease
• Inflammatory bowel disease
• Functional bowel disorders
• Congenital bowel disorders
• Emergency colorectal conditions
• Colorectal cancer
• Rectal cancer

What are the types of colorectal surgeries?

There are many types of colorectal surgeries. Your surgeon will be the right person to decide which surgery is ideal for you, depending upon your diagnosis and condition. Following are some of the colorectal surgeries:

• Laparoscopic colonic resection (SILS)
• Laparoscopic colonic resection
• Laparoscopic pouch surgery (SILS and transanal)
• Surgery for complications (fistula/ obstruction)
• Surgery of constipation surgery for obstructive defecation
• Surgery for incontinence
• Insertion of neuromodulation (SNS)
• Prolapse surgery (corrective and resection)
• Surgery for chronic pelvic pain
• Hirschbrung disease prolapse and others
• Bleeding/ perforation and obstruction
• Minimally invasive surgery
• Organ preservation rectal surgery
• Trans anal total mesenteric excision
• Robotic rectal resection
• Stoma formation and reversal

What is a Colectomy?

A colectomy, or, colon resection, removes all or part of the large intestine.

• Segmental colectomies: Generally, a vertical incision is made in the middle of the abdomen, overlying the portion of the bowel with disease. The segment of bowel containing the disease is removed. If the excision is for cancer, an effort is made to remove a wider segment to include lymph nodes. The ends of the bowel are joined together (anastomosis) to be water-tight and permit healing
• Polypectomy: A surgeon may remove a cancerous polyp or polyps from the colon or rectum using a colonoscope. The colonoscope is inserted into the rectum and a wire loop is passed through the instrument to remove the polyp
• Total colectomy and total proctocolectomy: A few diseases, such as familial polyposis, require removal of the entire colon with anastomosis of the end of the small bowel to the rectum. Familial polyposis or ulcerative colitis often require removal of the colon and rectum. A new pouch (neorectum) is created with the small bowel folded and stapled back on itself. This pouch is joined down to the anus

What is a colostomy?

A colostomy is a surgical procedure during which your surgeon creates a hole in your abdominal wall and pulls one end of the colon through the opening. Surgeons perform colostomy procedures to treat a number of colon and rectal conditions.

This procedure fundamentally alters how your body excretes waste and fecal matter. While you will need some time to get used to living with a colostomy, you will find that you can live a full life, complete with all the activities you enjoyed previously. The area where the new opening sits is called a stoma. This is where waste matter will exit your body. After your procedure, you will need a colostomy bag, which collects the waste from your body. The bag lies outside of your body. Before you are discharged, a trained ostomy nurse will teach you how to care for your stoma and manage the bag.

The colostomy is either temporary or permanent:

• Temporary colostomies: Performed for specific conditions that allow for the reattachment of the colon at later point in time. This allows the affected area to heal because the stool is not passing through the area. Once the affected area has healed, you undergo a colostomy reversal procedure
• Permanent colostomies: Are used in cases of chronic disease, such as Crohn’s disease and diverticular disease. Your surgeon may also remove the infected area of the colon or rectum

How long does it take to recover?

By six to twelve weeks most people are back to normal activity, with the exception of any work involving heavy lifting or prolonged and vigorous sports. As a general rule, listen to your body and use your common sense. Do not push yourself too hard. You do not have to put up with severe pain after surgery.

What will happen when I get home?

After returning home, you will resume your recovery. In case of any complications, you should call the hospital.

Call your surgeon immediately, if:

• You have a fever higher than 101.5 degrees
• Your wound is red, more painful or has drainage
• You are nauseated, vomiting or can’t keep liquids down
• Your pain is worse and not able to be controlled with the regimen you were sent home with
• You have ostomy output more than 1.5 L
• You experience diarrhea
• Are used in cases of chronic disease, such as Crohn’s disease and diverticular disease. Your surgeon may also remove the infected area of the colon or rectum