Colorectal Surgery

 

Colorectal surgery or surgery of the large intestines is major surgery which demands

skillful, disciplined and well trained surgeons.

The surgery can be elective or acute depending of the presentation of the patient.

Colorectal surgery can be indicated in the case of benign disease such as diverticulitis

or in the case of benign or malignant tumors (colorectal cancer).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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The surgery is done by taking away the affected piece of bowel. The bowel is then sutured or staplered back together and depending on the level of the bowel different reconstructing techniques can be applied.

 

One of the complications that can ensue after surgery is a non-healing of the bowel reconstruction (anastomotic leak)

this can occur in up to 10% in literature and can lead to mortality. Through training programs, postdoctorate education and sharing expertise a yearly very low rate of anastomotic can be achieved.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Indication: Benign and malignant tumors (cancer) or affected bowel

 

Classification Surgery: Major

 

Minimal invasive laparoscopic procedure: Yes

 

Expected hospital stay: 3-7 days hospitalisation (depending on technique)

 

Complications and measures

All surgery under general or regional anesthesia carries systemic risks  such as deep venous thrombosis, lungembolus, cardiovascular complications: These risks are minimised through preoperative screening procedures and prophylactic (preventing) measures (anticoagulation agents, antibiotics on indication)

 

Specific complications related to this surgery :

-Bleeding (low chance, less than 10%)

-Anastomotic leak (low chance, less than 10%) 

-Wound infection (low chance, less than 10%)

-Systemic complications related to major surgery e.g. pneumonia, cardiac problems (low chance, less than 10%).

 

 

 

 

The Bag

 

Sometimes a temporary or definitive ileostomy or colostomy is indicated

This is the so-called "stoma" or "bag" where the bowel is guided outside the abdomen.

Nowadays with modern material patients can do everything with a colostomy in place

We have a good reference for patient peer support through the local Rosa Foundation (Stichting Rosa)

which helps and guides patients with a temporary or definite ileostomy or colostomy. Contact information for this foundation can be found in the Patient Resource section of this site.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Modern surgery

 

Colorectal surgery can be done in an open classical fashion or a modern laparoscopic fashion with less surgical impact, complications, shorter hospital stay and better cosmetic results.

Laparoscopic colorectal surgery is considered highly advanced laparoscopy and is practice in the best centers.

The technique has been introduced safely in Curacao and the region through teaching courses and conferences.

In principle, every case is approached laparoscopically if possible.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This a video of an actual colorectal surgery case done by an AAH staff surgeon

it is used for educational purposes with consent of the patient.