Laparoscopic Hemicolectomies

Introduction

Laparoscopy is a surgery which has come up with many advantages almost 20years ago. It has been known by many names like minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery. Laparoscopic colorectal surgery has been accepted with open hands in medical field. As per the surgeons performing right hemicolectomy is more complicated using the laparo-assisted technique than open colectomy. Performing a completely laparoscopic right hemicolectomy is advisable in advanced laparoscopic centers only.After various research it has been concluded that the cancer recurrence ratio were similar between the laparoscopically assisted colectomy and open colectomy.


Benefits of laparoscopic hemicolectomy
  • .Less scars
  • Least risk in wounds
  • Less analgesic requirements
  • Fast recovery to normal activities.
  • Though its operative time is longer but hospital stay is shorter.
  • Minimal Postoperative pain

Sympotoms

The symptoms for laparoscopic right hemicolectomy are almost similar to those for open colectomy:

  • Inflammatory bowel disease(stool size, constipation etc.)
  • Colonic dysmotility
  • Bleeding from the rectum
  • Abdominal pain
  • Weight loss
  • Cramping
  • Blockage
  • Rectal prolapsed

Contraindications

  • Large phlegmonous mass
  • Extensive abdominal adhesions
  • Perforation
  • Obesity
  • Small bowel obstruction
  • Pulmonary embolus
  • Dehydration

Anesthesia

Without any much complications general anesthesia is given under the supervision of anesthesiologist.Before operation anesthesiologist go through with pre-op assessment identify f there is any high risk with patient like colon blood flow, stress response ,oxygenation . Antibiotic prophylaxis is recommended for prevention of surgical site infections but it should be always checked by surgeon before it is applied to patients.

Conclusion

Laparoscopic surgery has been shown to offer clear evidence of benefit when it is compared to open surgery. which we have already discussed above. Excessive research on laparoscopic skills can provide acceptable outcomes for surgeon in advanced right hemicolectomy . Laparoscopy is now seen an integral part of the practice of general and colorectal surgery. All operations carry a risk from anaesthetics point of view but this is minimal due to advanced techniques. As a result of concerns regarding adequacy of resection for cancer and the issue of port and wound site recurrences, there has been much caution. By far, patient wellness ,patient survival, disease progression, and cancer recurrence have been found to be similar between the laparoscopic and traditional open colectomy.In the process of Laparoscopic Right Hemicolectomy after the removal of diseased portion the two free end cells will be joined together and this is known as “ANASTOMOSIS” by the doctors. We expect by the fair outcomes in large,well designed & randomized trials of doctors will come up as more experienced hands,more accuracy and safety for the treatment of colon cancer will become even more clear.