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Laparoscopic Rectum Resection

What is Laparoscopic Rectal Surgery?

The rectum is the lower part of the large intestine that is connected to the sigmoid colon (lowermost part of the colon). The colon and the rectum (bowel) function to store and expel digested food and waste. Laparoscopic rectal surgery is the surgical removal of all or a part of the rectum with the aid of a laparoscope.

Rectal surgery is performed to prevent and treat various medical conditions associated with the rectum including rectal cancer, ulcerative colitis, inflammatory bowel or Crohn’s disease.

Diagnosis

Routine tests such as blood tests, X-rays, MRI or CT-scan are usually performed to diagnose the disease. Your doctor will perform a complete physical examination to make sure you have no conditions that could negatively affect the surgical outcome.

Preparation for Surgery

Advise your doctor about any medicines you are taking and those you should stop taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. You must stop smoking or drinking alcohol at least a week before the surgery. Do not eat or drink 6-8 hours before the surgery. Your bowel must be empty before the surgery. Laxatives and sometimes enemas are used to fully empty the rectum.

Laparoscopic Rectal Surgery

Laparoscopy is a minimally-invasive surgical procedure that uses a laparoscope to diagnose and treat various disorders. A laparoscope is a thin fiber-optic device fitted with a camera and lens. Images from the camera are transmitted to a large monitor so your doctor can view the inside of your body.

  • The procedure is performed under general anesthesia.
  • A few small incisions are made on your lower abdomen.
  • Gas is introduced into the lower abdomen for better visibility.
  • The laparoscope is inserted and images of the rectum are visualized on a monitor.
  • Special small surgical instruments are used to perform the surgery.
  • The damaged part of your rectum is identified and resected (cut out) using special surgical instruments.
  • At the end of the surgery, the healthy ends are reattached, the incisions are closed with sutures, and a dressing pad is applied.

In some cases, the complete rectum is removed and the anus is closed (Abdominoperineal resection) and you will have a permanent colostomy. An opening called a stoma is created by your surgeon on the outside of your body, through which feces will pass to be collected into a colostomy bag.

Recovery after Surgery

You will be discharged a few days after the surgery. Following the surgery, your surgeon may recommend that you follow certain measures for a successful outcome:

  • Retain the dressing over the incisions for the first few days.
  • Keep the surgical area clean and dry.
  • Pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed to manage pain.
  • Your surgeon may give you activity restrictions, such as not to lift heavy objects.
  • You should maintain a healthy diet and are advised to get out of bed and move around as soon as possible.
  • Regularly follow-up with your surgeon.
  • Progress to regular exercise under the guidance of your doctor.

When to call the Doctor

Call your doctor if you experience symptoms including:

  • Fever and chills
  • Increased pain
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Leg pain

Complications of Laparoscopic Rectal Surgery

Some complications of the surgery may include:

  • Infection
  • Injury to the uterus, bladder or blood vessels
  • Formation of scar tissue
  • Lower intestinal bleeding
  • Incisional hernia
  • Sexual problems

Advantages of Laparoscopic Colorectal Surgery

Laparoscopic colon resection surgery has numerous advantages when compared to open surgery including:

  • Surgery requires only a few small incisions
  • Less pain after surgery
  • Quick healing of scars
  • Shorter stay at the hospital
  • Quick return to drinking and eating
  • Quick return to normal activities
  • American College of Surgeons
  • American Society for Metabolic & Bariatric Surgery
  • American Medical Association
  • Case Western Reserve University
  • Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program