Laparoscopy of the intestine: features of the operation
Excision of part of the colon or the full removal is done in order to get rid of malignant tumors, inflammation or other pathology of the intestine.
Colon cancer is a common malignant disease affecting women as half of humanity, and men’s. At risk to get sick people from 70 years, with age, the incidence of abnormalities increases. Also at risk — people who have inflammatory bowel disease such as Crohn’s disease, colitis; suffering from polyps; having close relatives with cancer of this organ.
Depending on the localization of the malignancy can be symptoms: the presence of blood during bowel movements, diarrhea, constipation, bleeding, the appearance of holes in the bowel wall, bowel obstruction, weight loss for no reason, pain in the abdomen, spasms, deterioration of General health.
The treatment of colon cancer involves removing the tumor surgically. Taking into account the size and its location will determine the volume of operation and the need for removal of the colon. The colon may be completely or partially removed. If we are talking about partial removal, it only removes the part that is affected by the tumor. Mainly in the course of operative intervention is removed cecum
If the tumor is large or access is restricted, the physician offers the patient to undergo preoperative therapy entails chemotherapy in combination with irradiation. This method is aimed at reducing the size of the education before surgery, reducing the operation time and to simplify it.
The preparatory phase
All stages must be adhered to:
- To determine the localization and size of the tumor, the doctor prescribes the patient full colonoscopy, MRI of the digestive system, or a CT scan of the intestine.
- For suspected metastases in other organs and lymph nodes additionally assigned the survey of visualization techniques.
- Also the patient needs to pass a General analysis of blood and biochemical and clotting.
- Patients, aged over 40 years, also need to undergo an ECG.
- Before the operation the bowels using laxatives, you need to clean of bacteria and feces.
The last meal should be 6 hours before the operation.
The progress of the operation
Regardless, will be performed laparoscopy or open surgery, it takes place under General anesthesia. The patient will sleep without feeling pain. The method of operation of the intestine (open or laparoscopy) is determined by the size of the tumor, its properties and localization in the intestine.
If the surgeon considers it possible to conduct a laparoscopy, it will make the stomach 2 or 3 small incision, through which will be introduced surgical instruments. Near the navel will be made a small hole where you enter the laparoscope, equipped with a flashlight and camera. Over the course of the operation, the surgeon will watch the monitor screen, the image displayed by the camera of the laparoscope. With the help of the Veress needle, the surgeon introduces into the abdominal cavity carbonic gas, which provides access to the colon. Thereafter, the surgeon turns off the colon from the blood supply and removes. At the final stage of a laparoscopy, taking into account the condition of the patient, can be performed ileostomy or colostomy. When laparoscopy is completed, the surgeon closes the incisions and applies bandages.
Laparoscopy has the following advantages:
- smaller incisions;
- less pain;
- a shorter recovery period.
Despite this, not every patient surgery bowel can be done in a gentle method. If the patient is obese or has any adhesions in the pelvis, laparoscopy is contraindicated.
There may be cases when there is a need of translation of laparoscopy on open surgery. This decision is made by the surgeon during surgery and depends on the patient’s condition and difficulties arise during the procedure (severe bleeding, access to the colon laparoscopically impossible, etc.).
The postoperative period
After the operation laparoscopic method, the patient will be in hospital for approximately a week. A few days after the intervention may disturb the pain. If necessary, the doctor will prescribe painkillers. Immediately after the procedure, tumor removal, the patient may eat, but food must be soft. To a normal diet is allowed to come back on the 5th day after the procedure. In order to avoid complications, you need to follow a soft diet is more lying and not to make any sudden movements.
From sex to abstain for 6-8 weeks after surgery, avoid physical exertion. It is important to keep the area of skin where underwent laparoscopy, was dry and clean. If the patient was performed a colostomy or ileostomy, it instructed on how to care for the ostomy without the help of a specialist. If there is an ileostomy, the passage of time, the patient is prescribed another surgery, which aims to connect the ends of the colon. The sutures are removed only by a physician, and not earlier than 14 days after the laparoscopy. After the patient receives a referral to an Oncology unit to undergo maintenance therapy. If after surgery, increased body temperature (over 38 °C), it is necessary to immediately consult a doctor to determine the cause.