Colorectal Surgeries

Dr. Kolachalam, Colorectal Surgeries (Benign Cancer & Resection) 

 

 

The Conditions: Diverticulitis, Ulcerative Colitis, Crohn’s Disease, Rectal Prolapse, and Colorectal Cancer

 

The colon and rectum are part of your large intestine. The main purpose of these organs is to process and pass waste from your body.

There are several conditions that can affect your colon, such as: diverticulitis, ulcerative colitis, Crohn’s disease and rectal prolapse.

    • Diverticulitis is a condition in which a small pouch forms and inflames inside your colon. The most common symptom is abdominal pain. While diverticulitis has been linked to a low fiber diet, the exact cause is unknown.
    • Ulcerative colitis and Crohn’s disease are jointly known as inflammatory bowel disease (IBD). IBD causes the digestive tract to inflame. Symptoms may include: diarrhea, rectal bleeding, fever and weight loss. Five million people worldwide have IBD, but the exact cause is unknown.
    • Rectal prolapse occurs when tissue lining the rectum falls into the anus. The condition is more common in the elderly, and is often linked to constipation.
    • Colorectal cancer usually starts in the glands of the colon or rectum lining. Almost all cases of colorectal cancer begin as non-cancerous (benign) polyps that slowly develop into cancer. Like many cancers, colorectal cancer can spread to lymph nodes or other organs.

 

The Surgery: Colorectal Surgery  

Images of surgical incision options for colorectal surgery

Open Surgery incision comparison with minimally invasive surgery incisions

 

Treatment options often depend on how severe your symptoms are, how many episodes you have experienced, your age and overall health. If medicine and lifestyle changes do not ease your symptoms, your doctor may recommend surgery.

There are several types of operations that can be performed on your colon. When doctors remove the affected part of your colon and join together the remaining healthy bowel, this is known as a colectomy or colon resection.  When your entire colon is removed, it is called a total colectomy. When your colon and rectum are removed, it is known as a total proctocolectomy with ileo-anal pouch. A small pouch is created from the ileum (end of the small intestine) to the anus, which replaces the rectum.

If you are facing colon cancer, your doctor may recommend a colectomy. During a colectomy, part or all of your colon will be removed, depending on the extent of the cancer. For patients diagnosed with rectal cancer, surgeons typically perform a low anterior resection (LAR) to connect the rectum to the colon after removing the cancer. If the cancer is too close to the anus, your surgeon may need to remove your rectum, anus and part of your sigmoid colon. This is known as an abdominoperineal resection or APR.

 Colorectal procedures are often performed with open surgery, which requires a large incision, meaning a large open incision is made from your pubic bone to just below your breastbone as you can see in the photo to the right. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. Open surgery allows doctors to see and touch your organs as they operate.

Colorectal procedures can also be performed using minimally invasive surgery (laparoscopy). This means Dr. Kolachalam operates through a few small incisions in the abdomen using long-handled instruments and a tiny camera. The camera sends images to a video monitor in the operating room to guide your surgeon during the operation.

There is another minimally invasive surgical option for patients facing colorectal surgery: state-of-the-art da Vinci Surgery.  Below is an animation of a colectomy procedure using minimally invasive techniques such as laparoscopic techniques that are similar to da Vinci.

 

 

da Vinci Surgery: A Minimally Invasive Surgical Option  

image of daVinci hand size comparison

daVinci hand size comparison

 

If Dr. Kolachalam recommends surgery for diverticulitis, ulcerative colitis, Crohn’s disease or rectal prolapse, ask about minimally invasive da Vinci Surgery.

Using the da Vinci System, Dr. Kolachalam makes a few small incisions – similar to traditional laparoscopy. The da Vinci System features a magnified 3D HD vision system and tiny wristed instruments that bend and rotate far greater than the human wrist. These features enable Dr. Kolachalam to operate with enhanced vision, precision, dexterity and control.

As a result of da Vinci technology, da Vinci Colectomy offers the following potential benefits:

    • Precise removal of cancerous tissue
    • Low blood loss
    • Quick return of bowel function
    • Quick return to a normal diet
    • Low rate of complications
    • Low rate of converting to open surgery compared to traditional laparoscopy
    • Short hospital stay
    • Small incisions for minimal scarring

 

Risks & Considerations Related to Colectomy & da Vinci Surgery:

 

Potential risks of any colectomy procedure include:

    • Intestinal fluid leakage
    • Internal bleeding
    • Bowel blockage
    • Blocked lung artery
    • Abscess
    • Urinary problems
    • Wound infection

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