Laparoscopic Colorectal Surgery in Sydney

About Laparoscopic (Key Hole) Bowel Surgery

Laparoscopic, or key hole surgery has dramatically changed bowel resections. It has allowed surgeons to remove both large bowel (colectomy) and rectal (proctectomy) specimens through much smaller incisions than was previously possible.

The general principles of laparoscopic bowel resections are:

• Distending abdominal cavity with gas to allow ‘space’ to operate
• Operating with long instruments, usually through 5mm cuts or ports
• A single ‘extraction port’ which is the cut required to remove the specimen
• The length and location of this is dependant on what part of the bowel is removed and how big it is

There are advantages to laparoscopic surgery over conventional bowels surgery that have been proven with randomised controlled trials. These are:

• Less blood loss
• Less post-operative pain
• Quicker return of gut function
• Shorter hospital stay

One of the commonest reasons for a bowel resection is the treatment of colon cancer. The principles of bowel resection are identical for both open and laparoscopic operations – that is ensuring that there is a margin of normal tissue on either side of the cancer, and removing all of the lymph nodes with the cancer specimen.

Both of these vital steps have been shown to be no different whether the operation is performed laparoscopically or via open surgery. Local recurrence, distant recurrence and cancer related mortality have repeatedly been shown to be similar in these two groups of patients.

Depending on the type of bowel resection you require, you may not need bowel preparation. It is Dr Kariappa’s practice that only resections requiring a rectal anastamosis (join) require bowel preparation. This will reduce both your pre-operative discomfort as well as your degree of dehydration prior to your surgery.

The length of stay following a colonic (large bowel) resection is 3-4 days on average, and 5 days for a rectal anastamosis (anterior resection)