Indications:
Common reasons for this operation are:
- Diverticular disease
- Inflammatory bowel disease
- A stricture/narrowing causing blockage
- Cancer
Procedure:
A part of the bowel will be cut out and an anastomosis will be performed (the remaining ends sewn or stapled together). The amount of bowel removed varies, depending on the reason for the operation. This procedure can be performed using one of two approaches, namely, laparoscopically (key hole surgery) or open by performing an incision in the abdominal wall in the midline from above the belly button down to just above the pelvic bone.
There are numerous types of colectomies, namely:
- Hemi-colectomy (removing the left or right side of the colon or large intestine)
- Lower anterior resection (removing the lower part of the large intestine with the rectum)
- Total colectomy (removing the whole colon or large intestine)
- Bleeding – intra-operatively and/or post operatively.
- Leak of bowel content – due to damage or breakdown of tissue at the area where the bowel was joined. This occurs in less than 5-10% of patients. This complication can potentially be life-threatening and will most likely require another operation.
- Infection – can occur in the wound(s), lungs, drip site or internally where the bowel was removed.
- Deep vein thrombosis – blood clots forming in the deep veins of the legs, can occur with any surgery.
- Damage to surrounding structures – nearby structures, like the small intestine or the little pipes that carry the urine form the kidneys to the bladder can be inadvertently injured despite meticulous and careful operating technique.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Prepare colon with prescribed colon preparation and diet as issued by the reception.
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
Duration of hospital stay:
- 5-10 days (dependent on pain management, general state of patient and first bowel movement).
Activities:
- Refrain from strenuous activities (incl. exercise) for at least 4 post-operatively.
Back to work:
- Sick leave required post-operatively is approximately 14-21 days.
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
More procedures performed by Dr Jeske
A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.
THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.
AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.
THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.
PTC is a procedure performed by a radiologist (specialist X-ray doctor) who takes X-ray pictures of the bile ducts which are tubes inside the liver.
THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.