Colon and Rectal Surgeries
The colon, or large intestine, is the last part of the digestive system, measuring about 1.5 meters (5 ft). It starts from the end of the small intestine or ileo-ceacal junction in the right lower abdomen and extends to the rectum. The colon is divided into four portions: the cecum and ascending colon (right colon), transverse colon, descending or left colon, and sigmoid colon. Unlike the small intestine, the colon primarily absorbs water and electrolytes.
The rectum and anal canal, the terminal portions of the digestive system, store fecal matter before expulsion.
Common Disorders of the Colon:
- Colitis – Infection or inflammation of the large intestine
- Polyposis – Single or multiple growths, cancerous or non-cancerous
- Inflammatory Bowel Diseases (IBD) – Ulcerative colitis or Crohn’s disease
- Intestinal obstruction – Cancerous or non-cancerous like volvulus
- Diverticulosis – Small outpouchings in the colon
- Rectal prolapse – Protrusion of the rectum through the anus
- Recto-vaginal fistulas – Abnormal connection between the vagina and rectum
Symptoms:
- Abdominal pain, constipation, or reduced bowel movements
- Obstipation (no passage of gas), bloating, distension, nausea, vomiting
- Fevers, blood in stool, weight loss, appetite loss
- Incontinence, mass protruding from the anus
Diagnosis:
- Routine blood investigations, CRP, ESR
- Stool routine with occult blood, Fecal calprotectin
- X-ray abdomen and pelvis, Ultrasound abdomen and pelvis
- CT abdomen and pelvis with oral, IV, and rectal contrast
- MRI abdomen and pelvis, Colonoscopy, Sigmoidoscopy
- Special tests – MR Defecogram, Pudendal nerve motor latency tests
Treatment:
- Conservative: Treatment through medications or non-surgical methods
- Surgical: Minimal invasive techniques (Laparoscopy/Robotic surgery) or traditional open surgeries
Surgical Procedures:
Removal of the affected portion of the colon with reconnection of the healthy segments.
Complete removal of the colon for cancers or ulcerative colitis, with options for reconstruction.
Removal of the colon and rectum for conditions like polyposis or cancers.
Temporary or permanent diversion of the large intestine to an abdominal stoma.
Emergency surgery to remove a diseased portion of the colon, leaving an abdominal stoma.
Reconnecting the intestine after a Hartmann procedure to restore normal bowel function.
Removal of the rectum while preserving the anal sphincter to avoid a permanent stoma.
Removal of the rectum and anus, requiring permanent stoma creation.
Removal of early rectal tumors through the anus with laparoscopic equipment.
Laparoscopic or open techniques to reposition and secure the rectum.
Corrective surgery to repair abnormal connections between the rectum and vagina.
