On the day of your surgery, your health care team will take you to a preparation room. Your blood pressure and breathing will be monitored. You may receive an antibiotic medication through a vein in your arm.
You're then taken to an operating room and positioned on a table. You'll be given a general anesthesia medication to put you in a sleep-like state so that you won't be aware during your operation.
The surgical team then proceeds with your colectomy. Colon surgery may be performed in two ways:
- Open colectomy. Open surgery involves making a longer incision in your abdomen to access your colon. Your surgeon uses surgical tools to free your colon from the surrounding tissue and cuts out either a portion of the colon or the entire colon.
- Laparoscopic colectomy. Laparoscopic colectomy, also called minimally invasive colectomy, involves several small incisions in your abdomen. Your surgeon passes a tiny video camera through one incision and special surgical tools through the other incisions. The surgeon watches a video screen in the operating room as the tools are used to free the colon from the surrounding tissue. The colon is then brought out through a small incision in your abdomen. This allows the surgeon to operate on the colon outside of your body. Once repairs are made to the colon, the surgeon reinserts the colon through the incision.
The type of operation you undergo depends on your situation and your surgeon's expertise. Laparoscopic colectomy may reduce the pain and recovery time after surgery. But not everyone is a candidate for this procedure. Also, in some situations your operation may begin as a laparoscopic colectomy, but circumstances may force your surgical team to convert to an open colectomy.
Once the colon has been repaired or removed, your surgeon will reconnect your digestive system to allow your body to expel waste. Options may include:
- Rejoining the remaining portions of your colon. The surgeon may stitch the remaining portions of your colon together, creating what is called an anastomosis. Stool then leaves your body as before.
- Connecting your intestine to an opening created in your abdomen. The surgeon may attach your colon (colostomy) or small intestine (ileostomy) to an opening created in your abdomen. This allows waste to leave your body through the opening (stoma). You may wear a bag on the outside of the stoma to collect stool. This can be permanent or temporary.
- Connecting your small intestine to your anus. After removing both the colon and the rectum (proctocolectomy), the surgeon may use a portion of your small intestine to create a pouch that is attached to your anus (ileoanal anastomosis). This allows you to expel waste normally, though you may have several watery bowel movements each day. As part of this procedure, you may undergo a temporary ileostomy.
Your surgeon will discuss your options with you before your operation.
After your colectomy
After surgery you'll be taken to a recovery room to be monitored as the anesthesia wears off. Then your health care team will take you to your hospital room to continue your recovery.
You'll stay in the hospital until you regain bowel function. This may take a couple of days to a week. You may not be able to eat solid foods at first. You might receive liquid nutrition through a vein in your arm and then transition to drinking clear liquids. As your intestines recover, you can eventually add solid foods.
If your surgery involved a colostomy or ileostomy to attach your intestine to the outside of your abdomen, you'll meet with an ostomy nurse who will show you how to care for your stoma. The nurse will explain how to change the ostomy bag that will collect waste.
Once you leave the hospital, expect a couple of weeks of recovery at home. You may feel weak at first, but eventually your strength will return. Ask your doctor when you can expect to get back to your normal routine.
Nov. 13, 2012
- Patient information for laparoscopic colon resection from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. http://www.sages.org/publication/id/PI09/. Accessed Sept. 27, 2012.
- Townsend CM Jr., et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1565/0.html. Accessed Sept. 27, 2012.
- Surgery for colorectal cancer. American Cancer Society. http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-treating-surgery. Accessed Oct. 1, 2012.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Oct. 1, 2012.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 2, 2012.