Abdominal Surgery

Abdominal surgeries performed by our colon and rectal surgeons may include:

Segmental Colectomies
Generally, a vertical incision is made in the middle of the abdomen, overlying the portion of the bowel with disease. The segment of bowel containing the disease is removed. If the excision is for cancer, an effort is made to remove a wider segment to include lymph nodes. The ends of the bowel are joined together (anastomosis) to be water-tight and permit healing.

Abdominoperineal Resection
This surgery is performed to treat anal and distal rectal cancer. The anus, rectum and part of the sigmoid colon are removed to include the attending vessels and lymph nodes. The end of the colon is then brought through an opening made in the abdominal wall. This is called a colostomy.

Small Bowel Resection
This surgery is performed to remove Crohn's disease, cancer, ulcers, benign tumors and polyps. This surgery removes a portion of the small intestine. The surgeon will remove the diseased parts of the small intestine and sew the healthy parts back together. If necessary, an opening to the outside of the body called an ostomy is created.

Repair of Parastomal Hernias
The most common problem with an ostomy is a hernia. An ostomy is an abdominal wall opening, created to bring the bowel to the skin surface. Space next to the bowel in the abdominal wall permits fat or another loop of bowel to slip into the space. The hernia repair is made by closing the space with sutures or mesh; sometimes the ostomy is moved to another site on the abdominal wall.

Ostomy Creation and Revisions
An ostomy is a surgically created opening connecting bowel to the surface of the body. Ostomy revisions are surgeries to correct defects, such as protrusion or recession or hernia of the ostomy. The surgery is to make the ostomy protrude a small length so that it will accept an appliance more easily.

Low Anterior Resection
In this operation, part of the rectum is removed, but it is rejoined (anastomosed). Entailed in this operation is dissection deep into the pelvis. Anastomoses at this deep level are at increased risk to leak, so often, an ostomy is created above to stop the pressure of bowel movements. Another risk in the deep pelvic dissection is injury to nerves that serve the bladder and sex organs, which may cause later dysfunction.

Total colectomy and Total proctocolectomy
A few diseases, such as familial polyposis, require removal of the entire colon with anastomosis of the end of the small bowel to the rectum. Familial polyposis or ulcerative colitis often require removal of the colon and rectum. A new pouch (neorectum) is created with the small bowel folded and stapled back on itself; this pouch is joined down to the anus. A temporary ostomy is often included.

Repair of Rectal Prolapse
Treating rectal prolapse most often requires surgery. Surgery for rectal prolapse entails pulling the rectum back to its normal position and affixing it there.

What to expect for abdominal surgery

  1. Your doctor will give you bowel preparations for the day before your surgery. These typically include taking a laxative and not eating or drinking after midnight.
  2. Most abdominal surgeries last between several hours.
  3. You should expect to stay at MedStar Washington Hospital Center for seven days, plus or minus 3 days.
  4. The recovery period is different for each person, but most patients return to their usual routines in a one to three month period.
  5. A pain management regimen will be prescribed.
  6. If your surgery includes an ostomy, you will be taught how to care for it. Home care will be arranged as allowed by your insurance.

 

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