What is colon/bowel resection surgery?

Colon or bowel resection surgery is referred to as a colectomy, a procedure to remove a portion of the colon or the colon as a whole. Normally, you require a colectomy when parts of the colon or the colon itself appear non-functional. Usually, surgeons consider a colectomy when the colon is affected by cancer or inflammatory bowel disease.

A colectomy is labelled a "large bowel resection" because the colon forms part of the large bowel. By removing the affected portion of the colon, Dr Viljoen ensures the patient’s gastrointestinal tract functions optimally.

For example, a colectomy is performed to treat the following conditions:

• Colon cancer
  occurs when cancer begins inside the cells of the colon. Therefore, a piece of the colon may be resected to check for cancer and determine the stage of the disease.
• Pre-cancer
  can be determined during a procedure called a colonoscopy. A colonoscopy is a visual exam to check for changes in the colon leading to cancer.
• Obstruction in the large bowel
  occurs when there’s a blockage in the colon. Unfortunately, surgery is considered when other treatments cannot relieve the blockage or stricture in the large intestine is the cause of the obstruction.

Types of colon/bowel resection and other procedures

• Open colectomy
  is the surgical removal of the affected part of the colon through a large incision in the abdomen.
• Laparoscopic colectomy
  is the removal of the damaged parts of the colon through much smaller incisions in the abdominal cavity.

Another procedure that does not require resection of the colon includes the following:

• Strictureplasty
  is a procedure to treat a stricture in the colon by dilating the narrowed area in the intestine.

How do you perform colon resection surgery?

Open Colectomy

An open colectomy involves creating an expansive incision over the abdomen. A large incision allows easy access to the affected organs. While the patient remains sedated on general anaesthetic, Dr Viljoen may divide and remove the affected tissue in the colon. Next, the healthy ends of the bowels are reattached using sutures/staples. If he is unable to do this, he will fashion a stoma and attach the ends of the bowel to the stoma.

Laparoscopic colectomy

A laparoscopic colectomy is a less invasive procedure to remove affected tissue in the colon. First, Dr Viljoen makes small incisions in the abdomen to pass tiny surgical tools and a light-and-camera-equipped scope (laparoscope) through the cuts. Then, he removes the colon through one of these small cuts.