Laparoscopic Colectomy

Traditionally, the surgical removal of a part of the colon (“colectomy”) has been performed through a long incision in the middle of the abdomen. During such a procedure the whole large and small bowel are manipulated; this may cause a later return of bowel function. In addition, because of the length of the abdominal incision and the traction on the abdominal muscles, postoperative pain may be significant and require special regimens to be alleviated.

Nowadays, colectomy can be performed laparoscopically, or using the robotic technology. This is achieved through 4-5 very small incisions (0.5-1cm) and all operative maneuvers inside the abdomen (in order to remove a part of the colon and reconnect the two cut ends) are performed without disturbing the rest of the small and large intestine. This way, bowel function comes back to normal early after the operation and patients may resume their diet much earlier. Also, the very small length of the incisions and the lack of traction on the abdominal muscles lead to significantly less postoperative discomfort and much quicker recuperation. Generally, hospitalization is not longer than 2-3 days. In addition, there are other advantages as well:

1. Laparoscopic and robotic technology offer tremendous visual magnification compared to the bare eye in the “open technique”. This helps for the surgical maneuvers to be far more precise. This facilitates the safety of the operation and lowers the risk of any bleeding.

2. The visual acuity and precision helps identifying and preserving the nerves deep in the pelvis, which leads to preservation of sexual function postoperatively.

3. Laparoscopic visual magnification of the anatomic structures in the very bottom of the pelvis helps preserving the anal sphincter, so a permanent colostomy can be prevented and avoided. This is especially relevant to patients with tumors very low in the rectum, close to the anus.