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Minimally Invasive Colon Surgery and Laparoscopic Reversal of Colostomy

Colon Surgery

Laparoscopic colon surgery is a new technique that is rapidly gaining popularity. Advantages of laparoscopy over the open method of surgery include the following:

  • Colon function normalizes faster
  • Faster recovery time and shorter hospitalization
  • Less postoperative pain
  • Quicker return to normal activities
  • Smaller scar

Laparoscopic colon surgery was introduced in the early 90s. Yet today only 3% of all colon resections are performed this way in the United States. Explanations for this may include, surgeon resistance to accepting this procedure as comparable to traditional operations, lack of surgeon experience with minimally invasive techniques, and the fact that laparoscopic colon surgery is an advanced procedure which takes a long period of time to master.

How are Laparoscopic Colon Resection or Reversal of Colostomy Performed?

Laparoscopic Hand Instruments

“Laparoscopic” and “open” colon surgery are simply names describing the techniques a surgeon uses to gain access to the internal surgery site.

Most laparoscopic colon procedures start the same way. The surgeon makes about four or five small one-half inch long incisions. Using a ‘canula’ (a narrow tube-like instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a video camera) is inserted through the canula, giving the surgeon a magnified view of the patient’s internal organs on a television monitor. Several other canulas are inserted to allow the surgeon to work inside the abdomen, removing the diseased section of bowel and reattaching the healthy segments (a procedure called end-to-end anastomosis). A slightly larger incision is usually made to remove the diseased section of colon from the body. The entire procedure may be completed through the canulas or by lengthening one of the small canula incisions.

da Vinci Laparoscopic Surgery Robot

Laparoscopic colon surgery normally takes 2 to 3 hours. It may be performed using da Vinci robotic equipment. The patient is frequently out of the operating room more quickly than after an open procedure and there is no large incision to suture. Laparoscopic colon resection (removal of a  diseased portion) is performed for colorectal diseases including colon cancer.  In addition, for patients with previous colostomy, our surgeons are able to perform laparoscopic reversal of colostomy as well, restoring the normal flow of waste through the gastrointestinal tract.

 

Advantages of Laparoscopic Colon Resection or Reversal of Colostomy

Results may vary depending upon the type of procedure and the patient’s overall condition. Common advantages are:

  • Less postoperative pain
  • May shorten hospital stay
  • May result in a faster return to solid-food diet
  • May result in a quicker return of bowel function
  • Quicker return to normal activity
  • Better cosmetic results

What Complications Can Occur?

As with any operation, there is the risk of a complication, however, the risk is no higher than if the operation were performed using an open technique.

Slight risk:

  • Bleeding or infection (present with any operation)

Even smaller risk:

  • A leak where the colon was connected back together
  • Injury to adjacent organs such as the small intestine, ureter, or bladder
  • Blood clots to the lungs

What Happens if the Operation cannot be Performed or Completed by the Laparoscopic Method?

The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. The decision to convert to an open (conventional) procedure is strictly based on patient safety. As always, at Advanced Surgical Associates, the health and safety of our patients are the first consideration.