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LAPAROSCOPIC COLECTOMY / 腹腔镜结肠切除术 / PEMBEDAHAN USUS BESAR

October 11, 2017

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DR LAM RUEY SHYANG 蓝瑞祥医生


Laparoscopic Colectomy腹腔镜结肠切除术

 

What is a colectomy?

The colon (large intestine) is the last part of your digestive tract. This part of the bowel works to soak up water and store food waste. The colon is a tube-like muscle. This tube has a very smooth lining. The lining is made up of millions of cells. The colon in an adult is about 4 - 6 feet long. The rectum is the last 6 inches of the colon. A colectomy is surgery to remove all or part of your colon.

Right Hemicolectomy
Part or all of the ascending colon and cecum are removed. The colon is then reconnected to the small intestine.

Left Hemicoloectomy
Part or all of the descending colon is removed. The transverse colon is then reconnected to the rectum.

Sigmoid Colectomy
Part or all of the sigmoid colon is removed. The descending colon is then reconnected to the rectum.

Low Anterior Resection
The sigmoid colon and a portion of the rectum is removed. The descending colon is reconnected to the remaining rectum.

Abdominal Perineal Resection
Part of or all of the sigmoid colon and the entire rectum and anus are removed. A colostomy will be made. A colostomy creates an opening in your stomach wall so waste can pass from the body.

Why would I need a colectomy?

This is done to remove the disease causing your symptoms, such as:

For most people, this will cure the problem or at least greatly reduce their symptoms.

Symptoms

Symptoms of colorectal diseases include bleeding from the rectum, abdominal pain, change in bowel habits (new diarrhea, constipation, stool size, etc.), weight loss, anemia, cramping, vomiting, fever, among many others. Prior to undergoing surgery, your primary doctor or your surgeon will usually do tests (blood work, colonoscopy, barium enema, CT scan, etc.) to decide the cause of your symptoms. If you are found to have a disease that requires surgery, that is when a laparoscopic colorectal operation will be considered.

Description

Minimally invasive or laparoscopic surgery involves using multiple trocars (thin tubes) placed through 3 to 5 small incisions. These incisions are usually less than 0.5 cm (less than ¼ inch). Carbon dioxide gas is then used to slowly inflate the abdomen. A thin telescope is placed through one of the trocars. This allows the surgical team to view the inside of the abdomen on a TV monitor. Specialized instruments are placed through the other trocars to perform the operation. For colon surgery, one of the incisions is enlarged to remove the piece of colon. This larger incision can also be made initially, allowing one hand to be placed within the abdomen along with the camera and long instruments to assist with the operation. The procedure is performed under general anesthesia.

Advantages

Results are different for each procedure and each patient. Some common advantages of minimally invasive colorectal surgery are:

  • Shorter hospital stay
  • Shorter recovery time
  • Less pain from the incisions
  • Faster return to normal diet
  • Faster return to work or normal activity
  • Better cosmetic healing


LAPAROSCOPIC SURGICAL SCAR


OPEN SURGICAL SCAR

Many patients qualify for laparoscopic or minimally invasive surgery. However, some conditions may decrease a patient’s eligibility, such as previous abdominal surgery, cancer (in some situations), obesity, variations in anatomy or advanced heart, lung or kidney disease.

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DR LAM RUEY SHYANG 蓝瑞祥医生
MBBS (IMU), MRSC (Ireland), Master of surgery (UM), Diploma in Minimal Access Surgery (DMAS) , Fellowship in Minimal Access Surgery (FMAS)
Speciality : General Surgery, Laparascopic Surgery
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