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Surgeons performing laparoscopic surgery. As of 2012, more than 40% of colon resections in the United States are performed via a laparoscopic approach. [5] For laparoscopic colectomy, the typical operative technique involves 4-5 separate incisions made in the abdomen.
The colon is then mobilized from the retroperitoneum. Care is taken to avoid injury to the ureters and duodenum. The surgery then follows the same steps as small bowel resection. However, due to the colon's placement in the retroperitoneum, more dissection is often required to allow for tension free anastomosis. [5] [6]
The first video-assisted laparoscopic surgery was performed in 1987, a laparoscopic cholecystectomy. [54] Before this time, the operating field was visualised by surgeons directly via a laparoscope. In 1987, Alfred Cuschieri performed the first minimally invasive surgery in the UK with his team at Ninewells Hospital after working with multiple ...
The laparoscopic approach is safer than open surgery, [4] and there is less risk of complications after the procedure. [23] There is also less blood loss, less pain after the procedure, shorter average length of stay in hospital and faster recovery.
Proctocolectomy is the surgical removal of the entire colon and rectum from the human body, leaving the patients small intestine disconnected from their anus. [1] It is a major surgery that is performed by colorectal surgeons, however some portions of the surgery, specifically the colectomy (removal of the colon) may be performed by general surgeons. [2]
Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. [1] The field is also known as proctology , but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular.
William Ernest Miles (1869–1947), an English surgeon first performed the surgery of removing the rectum in 1907. He assumed that the rectal cancer can spread in both upwards and downward directions, thus necessitating the removal of the entire rectum together with the anal sphincters, resulting in a permanent stoma by connecting the proximal end of the descending colon to the skin.
The Hartmann's procedure with a proximal end colostomy or ileostomy is the most common operation carried out by general surgeons for management of malignant obstruction of the distal colon. During this procedure, the lesion is removed, the distal bowel closed intraperitoneally, and the proximal bowel diverted with a stoma .
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