The large bowel which is medically referred as sigmoid colon has three sides. The ascending colon on the right side is followed by the transverse colon and the end portion of the colon is known as the descending colon. The primary treatment option for colon cancer is the surgical removal of the cancerous part of the colon along with the surrounding lymph nodes. The remaining colon parts are joined together and this process is known as anastomosis. When the descending colon is affected by cancer, the left colon is removed and the remaining colon is connected to the transverse colon.
Most of the colon and rectal surgeries are carried out using minimally invasive procedure known as laparoscopic procedure. In this procedure a laparoscope is guided carefully through a cannula inserted through a small incision made near the umbilicus. Laparoscope is an instrument which has a light source and a camera on one end of a long flexible tube and the other end of the tube is connected to a monitor placed inside the operation theater. Other special miniature instruments for carrying out the surgery are inserted through other small incisions in the belly. The surgeon will be able to get an enlarged view of the video taken by the laparoscope in the monitor placed near him. Seeing this video he performs the surgery controlling the special devices remotely. If the rectum has also inflicted by cancer the rectum will be removed and the end part of the colon will be connected to a stoma made near the bottom left side of the abdomen. A pouch will be connected to this stoma which will act as a storage place for the waste coming out of large intestine. As this stoma is not having any mechanism to open when needed, the waste will be coming out continuously. The pouch will be detached and cleaned periodically and reattached to the stoma to continue its usage.
The benefits of laparoscopic surgical procedure include lesser pain, faster healing and earlier return of bowel functions. But generally laparoscopic procedure are not suitable for patients who are obese and have diabetics, hyper tension etc. The patient who had earlier undergone a surgical procedure in the abdominal area are also not suitable for laparoscopic colectomy. You have to consult the surgeon and confirm whether you are suitable for this type of surgical procedure.
As the surgeon cuts and removes the colon, the pathologist carefully examines the cancer using a microscope. If the cancer has spread to lymph nodes or if the cancer is spreading at a faster rate, the oncologist may suggest treatment with chemotherapy.
Care after surgery
After the surgery frequent bowel movements may be noticed for some days. This will become normal by about one year. Your doctor may suggest a bowel care plan to make the bowel normal faster. Recurrence of cancer is a possible drawback of surgical procedure in colon cancer and this may normally occur within two years after the surgery. After care and follow up check up by the oncologist, surgeon and gastroenterologist are very important. During periodic checkups physical examination and diagnostic tests like colonoscopy, blood tests CT scans etc are usually performed