Colorectal cancer is the second most common causes of cancer deaths. Colon consists of three parts. The first part of the colon commences from the small intestine and it ascends vertically and hence this part is known as the ascending colon. After this part the colon runs in horizontal direction from right side to left side of the abdomen and this part is known as the transverse colon. The last part of the colon is the descending colon which descends from the transverse colon and reaches the rectum.
Right hemicolectomy is usually performed as a laparoscopic procedure to remove the right side of the colon which is inflicted with cancer or for non- cancerous conditions like Crohn's disease. In this surgery the right part of the colon and a portion of the small intestine are usually removed. This process involves removing of lymph nodes and blood vessels of that area also. The surgeon then connects the remaining part of the small intestine and the large intestine together. Sutures or special staples are used for this purpose. Usually this surgery takes only 2 hours. In this type of surgery there is no requirement to make a stoma. If a stoma is required the surgeon will discuss the matter in advance with the patient and if so the time required for the surgery may increase. This procedure can be done in the conventional open method or minimally invasive laparoscopic method.
What is laparoscopic method?
Laparoscopic method is a minimally invasive method in which operation is carried out with two to three small incisions of the size 1 to 2 cms. In this surgery the surgeon is not conducting the surgery directly with his hands. Through one on these small incisions a laparoscope which is a miniature camera used to take the video of the internal organs and the surgery being carried out, is inserted. Through other incisions special instruments for carrying out the surgery are inserted. By viewing the videos of the surgery and the organs though a monitor placed in front of the surgeon, he carries out the surgery controlling the special instruments inserted for this purpose. As the incisions are small there will be less blood loss, pain etc and the possibility of faster healing and earlier recovery is also there.
1) The possibility of wound infections is there in this type of surgery. If infections occur antibiotic treatments can followed to solve the problem. 2) The possibility bleeding is less. But if there is considerable bleeding blood transfusion will be necessary. 3) In Crohn's disease the possibility of anastomotic leak is greater and in such cases if the leak cannot be managed by antibiotics another operation will be necessary in which a stoma will be created by the surgeon 4) In some cases the bowel may remain blocked and may cause problems. In such cases the surgeon may suggest bowel rest for a particular period. 5) Sometimes the surgeon may find it difficult to complete the surgery as a laparoscopic procedure and may be compelled to change the operation to an open surgery.
After the laparoscopic surgery
Intravenous drip will be provided after the surgery until the patient becomes capable of normal fluid intake. A catheter tube will be inserted permanently for a few days to the bladder for the passage of urine. The patient will be allowed to eat and drink as soon as he feels he is ready for the same. Hospital stay for 2-4 days only is needed for laparoscopic surgery. Patients will be encouraged to mobilise themselves at the earliest, but lifting weight or strenuous physical activity has to be avoided for 6 weeks.