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Laparoscopy is New Option for Colon Surgery

Posted on: Monday, 20 March 2006, 09:01 CST

By Juana M. Gyek, The Sun, Yuma, Ariz.

Mar. 20--Patients needing colon surgery can now recuperate faster and spend less time in the hospital.

Dr. George Deckey is now performing a hand-assisted laparoscopic colon surgery, a new procedure for the community that just became available here a few months ago.

Although this surgery is more commonly performed for colon cancer, it can also be performed for other colon diseases.

The procedure performed in a laparoscopic surgery for colon cancer is essentially the same as an open surgery but it is less invasive.

The recovery time for patients who have gone under the laparoscopic surgery is shorter and they encounter less pain and scarring. Their hospital stay is cut from six days for open surgery to two or three days, said Deckey.

"I was just amazed patients recovered so quickly," he said.

The laparoscopic surgery involves making three incisions in the torso, two dime-sized cuts and one 3- to 4-inch cut that is big enough for the doctor to place his hand inside the patient.

An open surgery requires an incision of up to 12 inches long from the upper to lower abdomen to have enough room for the surgeon to view the colon.

With either type of surgery, the section of the colon is cut on each side of the area where the cancer has grown and it is removed along with the surrounding areas and nearby lymph nodes to make sure that all the cancer is taken out.

The colon is then stapled to be reattached and inflated so that it is hollow again.

Once the intestine starts to work again, the patient is recuperated. Deckey has seen his patients recover faster after the laparoscopic surgery even though the same steps in removing the cancerous colon parts are done in both types of surgeries.

"It's still a mystery," he said.

However, he noted that in laparoscopic surgery, there is less trauma to the organ tissue, so the patient has less pain. As a result, the patient feels better, has a good appetite and needs less pain medication.

During laparoscopic surgery, carbon dioxide is used to inflate the patient's torso and provide more room for the doctor to work.

A video camera and a harmonic scalpel are inserted in the smaller cuts while an instrument is placed in the bigger opening that keeps air from escaping during the surgery.

The camera lens is located at the end of a metal tube that is inserted into one of the smaller openings. A bright bulb lights the area inside, while the lens provides a magnified view of the patient's internal organs on a monitor.

The colon is a continuous hollow tube surrounded by muscles. It's an organ that is hard to see, Deckey said.

With the camera, "I can really see very well and it allows me to do things better and more safely," he said.

The harmonic scalpel is used to cut and seal tissue, he said. "It heats and welds the tissue," preventing the organ from bleeding when it is cut.

During a surgery, doctors depend on their sense of touch, sight and even smell in order to perform a successful surgery, said Deckey.

With the advantage of having the hand inside the patient, the sense of touch is not lost.

"That's a huge advancement," Deckey said. "This is the way I plan to do all these (colon) surgeries."

He said that patients who have had many surgeries in the past might not be good candidates for this procedure because the scar tissue does not allow for the area to expand when the carbon dioxide is used.

And the surgery can be difficult in extremely obese people because it is hard to see everything inside, he said.

He also tells patients there is always the possibility that the he may have to convert from laparoscopic surgery to an open surgery if difficulties arise.

Juana M. Gyek can be reached at jgyek@yumasun.com or 539-6872.

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Copyright (c) 2006, The Sun, Yuma, Ariz.

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Source: The Sun (Yuma, Ariz.)

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