Laparoscopic surgery is a minimally invasive method that makes it possible to perform the usual operative procedures through 3 to 5 small openings of 0.5 to 1 cm in length. Through these openings, the surgeon places special ports with a diameter of 5 to 10 mm. The abdomen is inflated with carbon dioxide, thus providing the necessary space to manipulate the internal organs. Through the openings in the abdomen, a high-definition camera and instruments are introduced, which differ significantly from those of open surgery. The image is watched by the surgeons on monitors, magnified many times. In laparoscopic colon surgery, it is necessary to use high-tech instruments for cutting the tissues, stopping blood and joining the intestines (anastomosis). Indications for removal of a temporary unnatural anus do not differ between open and laparoscopic surgery, and this is most often required for tumors located close to the anus. Usually, the unnatural anus is surgically closed about 6 weeks after rectal resection. The section of colon or rectum, together with the tumor and lymph nodes, is removed from the abdomen through a minimally sized separate incision or opening, through which the temporary unnatural anus is subsequently formed.
For patients, who are thinking between open and laparoscopic surgery, it is helpful to know that performing a volume-adequate open colon and rectal resection involves an incision in the abdominal wall from the lower sternum to the pubic bone.
What are the advantages of laparoscopic surgery?
Laparoscopic surgery is characterized by much less postoperative pain and minimal need for postoperative anesthesia. The hospital stay is shorter and the patient recovers his normal bowel function more quickly by returning to a normal diet and to his usual physical activity. The laparoscopic method avoids complications typical of open surgery: purulent infection of the surgical wound, postoperative hernias, postoperative adhesions, and others, and the cosmetic result is significantly better.
In what cases can the operation not be performed laparoscopically or must it be completed by an open route?
Of course, there are cases in which the operation must be carried out by an open route. This is most often required in patients with severe obesity or severe adhesions from previous abdominal surgeries. Sometimes there is an impossibility to visualize and/or separate the organs, due to anatomical features or uncontrollable bleeding during the operation. Very advanced tumors also require conventional surgery. Switching to open surgery is a decision that the surgeon must take, aimed solely at ensuring the safety of the patient!
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