Colon surgery

Less invasive may be best way

 

A minimally invasive laparoscopic procedure to treat diverticulitis — a painful condition caused by the inflammation of pouches in the colon — and colon cancer has been around for more than 20 years.

But many surgeons continue to perform an open colectomy, causing a larger incision to the abdomen, a longer recovery period and increasing the risk of complications.

“When you’re looking at a minimally invasive procedure compared to an open procedure, you’re shaving off maybe an average of two days in the hospital,” said Dr. Charan Donkor, a general and bariatric surgeon at Baptist Health Medical Group and Mariners Hospital.

Surgery is recommended for patients who have had multiple attacks of diverticulitis. The procedure removes the diseased portion of the colon, usually the sigmoid colon, which is found near the end of the large intestine just before the rectum. According to the National Digestive Diseases Information Clearinghouse, 10 to 25 percent of people diagnosed with diverticulosis end up getting diverticulitis. With an open colectomy, a long vertical incision is made to the abdomen to access the colon; surgery normally takes two to three hours. The average hospital stay is five to seven days — sometimes longer — and postoperative pain is severe. Common complications include infections and abscess.

The minimally invasive procedure has a much shorter recovery period, usually three to five days. There is less risk for wound infection as instead of one large incision, several smaller incisions are made.

Although Donkor says it has been proven that a minimally invasive approach to surgery is an “overall improvement for the patient,” a recent study showed that only 30 to 40 percent of individuals undergoing elective colon surgery are having the minimally invasive approach.

According to the U.S. National Library of Medicine, minimally invasive approaches to colon surgery have documented benefits including patients’ earlier return to their daily routines and earlier return of gastrointestinal function.

Donkor says that not every patient experiencing diverticulitis or colon cancer is a candidate for minimally invasive surgery, but the option should be explored.

“If patients are candidates, or feel that they may be candidates, it definitely would be better for them to opt for the minimally invasive surgery,” he said. “It is just as safe, if not safer, and patients tend to do better.”

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