Colorectal Surgery

What is Colorectal Surgery?

The colon is another name for the large intestine. The rectum is the lower part of the large intestine that is connected to the sigmoid colon (lowermost part of the colon). The colon and the rectum (bowel) function to store and expel processed food and waste. Colorectal surgery is the surgical removal of all or a part of the colon or the rectum.

Some of the common conditions treated by colorectal surgery include:

Benign or malignant growth (cancer) in the colon or rectum
Crohn’s disease
Diverticulitis
Hemorrhoids
Untreated constipation

Preparing for Colorectal Surgery

Talk to your doctor about the medicines you are taking and those you should stop taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. You must stop smoking or drinking alcohol at least a week prior to surgery. Do not eat or drink six to eight hours before the surgery, as your bowel must be empty in preparation. Laxatives and enemas may be given to empty your bowel completely.

Procedure of Colorectal Surgery

Colorectal surgery may be performed laparoscopically or as open surgery.

Laparoscopic Colorectal Surgery

Laparoscopy is a minimally-invasive surgical procedure that uses a laparoscope to diagnose and treat various disorders. A laparoscope is a thin fiber-optic device fitted with a camera and lens. Images from the camera are transmitted to a large monitor so that your doctor can view the inside of your body.

The surgical procedure involves the following steps:

General anesthesia is given.
Three to five small incisions are made in your abdomen.
Gas is introduced into the abdomen for better visibility.
The laparoscope is inserted.
Images of the internal organs are visualized on a monitor.
Special small surgical instruments are used to perform the surgery.
Any growths, tumours or abnormalities of your colon or rectum may be removed, depending on the medical condition.
Your surgeon may convert to open surgery under circumstances such as excessive bleeding.
Your surgeon administers internal sutures (if necessary).
The incisions are then bandaged.

Open Colorectal Surgery

Certain colorectal conditions cannot be treated by laparoscopy. Your surgeon will suggest an open procedure under certain conditions including:

The organs cannot be clearly visualized with a laparoscope
Obesity
There is scar tissue present due to previous abdominal surgery
Large tumours are present

The procedure is performed under general anesthesia. A large incision is made on your lower abdomen. The damaged part of your colon or rectum is identified and resected (cut out) by using special surgical instruments. At the end of the surgery, the healthy ends are reattached, the incisions are closed with sutures, and a dressing pad is applied.

In some cases, the resected part of your colon cannot be joined with the rectum and you will require a colostomy. An opening called a stoma is created by your surgeon on the outside of your abdomen, through which feces pass and are collected in a colostomy bag. In some cases, the complete rectum is removed and the anus is closed (abdominoperineal resection) and you will have a permanent colostomy.

Recovery after Colorectal Surgery

Following the surgery, your surgeon may recommend that you follow certain measures for a successful outcome:

Keep the dressing over the incision for the first few days.
Keep the surgical area clean and dry.
Pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) can be prescribed to manage pain.
Your surgeon may give you activity restrictions, such as not to lift heavy objects.
Maintain a healthy diet.
You are advised to get out of bed and move around safely as soon as possible.
You should follow up regularly with your surgeon.

Complications of Open Colorectal Surgery

As with any surgery, complications can occur. The complications related to colorectal surgery may include:

Infection
Injury to the uterus, bladder or blood vessels
Formation of scar tissue
Intestinal bleeding
Incisional hernia