Colon Resection
A colon resection is a surgical procedure for removing part or all of the colon from the body. This procedure is also called a colectomy. The colon is a segmented, five-foot section of the large intestine in which digested food gradually takes the form of excrement. A healthy large intestine is critical for the elimination of potentially harmful, solid waste products from the body. The colon is subject to a variety of diseases and other medical conditions that may dictate the need for surgery. A colon resection is followed by a second procedure, to ensure the proper functioning of the gastrointestinal tract.
There are several types of colon-resection procedures:
- Partial colectomy: A part of the colon is removed, leaving the remainder intact.
- Hemicolectomy: The colon’s entire right or left side is removed. In a transverse colectomy, the upper section is targeted.
- Sigmoid colectomy: Sigmoid surgery removes the segments of the colon nearest the rectum.
- Total colectomy: The entire colon is removed, up to the rectum.
- Proctocolectomy: The colon and rectum are both removed.
A colon resection is generally regarded as major surgery. Longer-than-average times are required for both the procedure and the recovery period.
Colectomies are performed by means of open surgery, minimally invasive laparoscopic surgery, and minimally invasive robotic surgery. In a robot-assisted colectomy, the medical team uses sophisticated tools that replicate human movement and boost surgical success. Robot-assisted colectomies are performed at Baptist Health facilities in Kentucky and Indiana.
Who Is a Candidate for a Robot-assisted Colectomy?
Colectomies are the surgical means of treating a number of conditions for which medications have proven ineffective or which may result in a medical emergency. Included among these are:
- Bowel obstructions
- Crohn’s disease
- Colon cancer
- Diverticulitis
- Gastrointestinal bleeding
- Ulcerative colitis
Colon resections are sometimes used preventively, with patients showing a predisposition for colorectal cancer, due to the regular presence of intestinal polyps and a family history of the disease.
Your physician will determine your suitability for colon surgery by analyzing your medical history and symptoms and ordering a number of tests. These might include bloodwork, an electrocardiogram or EKG, X-rays, a urinalysis, and a colonoscopy. If your condition warrants it, you will be scheduled for an inpatient procedure. You will be asked to refrain from eating or drinking for several hours prior to the operation. You will also be required to drink a purgative, to clear your bowels beforehand.
Many colectomies are now performed as laparoscopic procedures. This includes robot-assisted colon resections. There are a few exceptions. In unusually complex situations, open surgery may be required. If your abdomen is excessively scarred from previous surgeries, alternative treatments may be attempted.
Benefits of Robotic Surgery
It is important to note that a robotic procedure does not mean being operated on by a machine, rather than a fellow human. Robotic procedures are robot-assisted procedures, where the robot is a group of tools used by a surgeon and his or her medical team to aid in an operation. These tools are called robots because they mimic human motions and movements, sometimes with greater precision than we’re capable of.
A robot-assisted colectomy is a minimally invasive procedure involving three to five minor incisions. It offers these benefits:
- Smaller incisions than with open surgery, and therefore less blood loss
- Reduced scarring
- Lower risk of infection
- Decreased post-surgical pain
- Shorter hospital stays
- Quicker recovery times
- Fewer post-operative complications
- Faster return to normal living
How Does Robot-assisted Colon Resection Work?
At Baptist Health, robot-assisted colectomies are performed with the aid of the Intuitive da Vinci system. Intuitive is a leading American manufacturer of medical robots and related equipment.
The Intuitive da Vinci system has three parts:
- a multi-armed robot for inserting cameras and other surgical instruments in the patient
- a vision cart with endoscopic monitors that provide the surgeon with magnified, real-time images of the surgical site within the body
- a computerized panel from which the surgeon controls the robot and performs the procedure
A robotic colectomy is conducted similarly to laparoscopic and other forms of minimally invasive surgery. The surgeon makes tiny incisions for the insertion of a three-dimensional camera – the surgeon’s eyes during the procedure – and other operating instruments for the detachment and removal of the targeted segments of the colon. However, a robot-assisted procedure has the advantage of greater precision than a human operating alone because robot technology downscales the surgeon’s hand motions to extremely fine movements, reducing the possibility of organ or tissue damage.
Joining the surgeon and the robot in the operating room are the entire surgical team, including the anesthesiologist, the nurses, and a second surgeon or surgical assistant for moving the robot into positions that aren’t mechanically controlled.
What to Expect with Robot-assisted Colon Resection
Discuss the procedure with your physician beforehand, including any medically necessary steps prior to coming to the hospital. You’ll be anesthetized and wholly unconscious during the operation. Once your colon is removed in whole or in part, your surgeon will perform one of several procedures to restore the integrity of your gastrointestinal system, depending on how much of your colon remains. These procedures include:
- Anastomosis: In this procedure, the two ends of your colon are surgically rejoined, enabling the large intestine to function as it has in the past.
- Colostomy or ileostomy: Both of these procedures connect the intestinal tract to an external pouch through a hole in the abdominal wall. This hole is called a stoma. The pouch serves as a collection point for food waste. This arrangement is sometimes temporary and can be eliminated during an additional surgical procedure.
- Illeal pouch: In the case of a proctocolectomy, where the entire colon and rectum have been removed, the small intestines can sometimes be connected directly to the anus by means of an illeal pouch. The latter is roughly analogous to the external pouch described above in the ostomy procedures.
Following a colon resection, you’ll remain in the hospital until you regain control of your bowels. This typically takes from two days to a week. A full recovery from surgery takes up to six weeks. Your physical activity will be limited during this period. You will begin your recovery on a liquid diet, gradually incorporating solid foods in greater volume and variety over time.
Know Your Risk
Baptist Health is committed to being a leading medical provider of robot-assisted diagnosis and surgery in Kentucky and Southern Indiana. If you have questions or concerns about your colorectal health, contact your Baptist Health primary care provider.