Minimally Invasive Intestinal Surgery

Each year, more than 800,000 surgical procedures are performed in the United States to treat a number of intestinal diseases. Although surgery is not always a cure, it is often the best way to stop the spread of disease and alleviate pain and discomfort.

Patients undergoing intestinal surgery often face a long and difficult recovery because the traditional "open" procedures are highly invasive. In most cases, surgeons are required to make a long incision, resulting in an average hospital stay of eight days and up to six weeks of recovery.

Now, a new technique known as minimally invasive, or laparoscopic, intestinal surgery allows surgeons to perform many common intestinal procedures through small incisions. Depending on the type of procedure, patients may leave the hospital in as little as three days and return to normal activities more quickly than patients recovering from open surgery.

What is the intestine?
The intestine is a long, tubular organ consisting of the small intestine, the colon (large intestine) and the rectum (last eight to 10 inches of the colon). After food is swallowed, it mixes with digestive agents in the stomach and then empties into the small intestine. Once in the small intestine, where nutrients are absorbed. The remaining waste moves through the colon to the rectum and is expelled from the body.

What is minimally invasive intestinal surgery?
In most minimally invasive intestinal procedures, surgeons operate through three to five tiny openings (approximately 1/2-inch) while viewing a magnified image of the patient's internal organs on a television monitor. In some cases, one of the openings may be lengthened by three inches to complete the procedure. In open intestinal surgery, eight to 12 inch incisions are not uncommon.

What intestinal diseases can be treated with the minimally invasive technique?
Minimally invasive surgery has been used to:

• Treat diverticulitis (a condition in which small, pea-size pouches that form in the walls of the intestines becomes infected and inflamed)
• Remove non-cancerous polyps (growths)
• Treat some forms of colon cancer
• Treat inflammatory bowel disease (IBD), most often classified as ulcerative colitis or Crohn's disease (IBD is a group of chronic disorders that cause inflammation or ulceration in the small and large intestines)

Am I a candidate for minimally invasive surgery?
Although there are many benefits associated with minimally invasive surgery, it’s not for everyone. Those who have had previous abdominal surgery or who have some pre-existing medical conditions may not be candidates for minimally invasive surgery. To determine if the technique is appropriate for your surgical needs, a surgeon qualified in minimally invasive surgery should work in consultation with your primary care physician to give you a thorough medical evaluation.

How are less invasive procedures performed?
Most minimally invasive intestinal procedures start the same way. Using a trocar (a narrow tube-like instrument), the surgeon gains access to the abdomen. A laparoscope (a tiny telescope connected to a video camera) is inserted through the trocar, giving the surgeon a magnified view of the patient's internal organs on a television monitor. Up to four additional trocars are inserted for special instrumentation.

One of the most common procedures, laparoscopic colectomy, involves removing part of the colon. The surgeon operates through three to five trocars to seal and cut the vessels surrounding the affected area using an instrument such as the MULTIFIRE ENDO GIA* stapler. Depending on the patient's condition and the surgeon's judgment, the procedure may be completed laparoscopically or by lengthening one of the small trocar incisions.

What are the advantages of the minimally invasive technique?
Because surgeons operate through three to five tiny openings instead of a long incision, many patients experience less pain, less scarring and a shorter hospital stay. In some cases, a quicker return to work and other normal activities is possible. In addition, these patients often eat solid foods sooner and experience a quicker return of normal bowel function.

How long will I be in the hospital?
Many patients leave the hospital three to five days after minimally invasive intestinal surgery. This compares with a five to 10 day stay following the traditional open procedures.

What can I expect after surgery?
After surgery, it is important to follow your doctor's instructions. Although many people feel better in just a few days, remember that your internal organs still need time to heal. So if your doctor says take it easy for a week or two, take it easy!

Should I be concerned that the minimally invasive technique is new?
Minimally invasive surgical techniques have been used in gynecologic surgery for nearly three decades, and today, more than 90 percent of all gallbladder surgery is performed using these techniques. More recently, surgeons have applied minimally invasive techniques to a broad range of procedures, including hiatal hernia repair, appendectomy, hysterectomy and surgery for GERD.

Before undergoing any type of surgery, whether minimally invasive or open, be sure to ask your surgeon about his or her training and experience.

Advantages of minimally invasive intestinal surgery

• Less postoperative pain
• Faster return to solid diet
• Better cosmetic results
• Quicker return of normal bowel function
• Shorter hospital stay
• Quicker return to normal activity

Results may vary depending upon the type of procedure and patient's overall condition.

 

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Meridian Surgery Center and Cascade Hernia Institute are conveniently located in the heart of Pierce County, just south of Seattle and east of Tacoma, in the city of Puyallup, Wash.