Colorectal Surgery India,Cost Colorectal Surgery Bangalore India
Colorectal Surgery India,Cost Colorectal Surgery Bangalore India
Colorectal Surgery
Colorectal surgery repairs damage to the colon, rectum, and anus through a variety of procedures that may have little or great long-term consequence to the patient. It may also involve surgery to the pelvic floor to repair hernias...
Gastro-intestinal surgery in general and colonic surgery in particular is considered as very demanding and requires - high degree of operative skill. In the discovery of the last decade is an attempt to minimize these injuries for patients benefit Laparoscopic colonic surgery is being accepted by many centres as primary line of treatment for carcinoma colon. It is no more considered an experimental work. Centres specialised in this field have conducted double blind randomised trial (DBRT) in large number of cases and have shown that the basic principles of oncosurgery are not compromised and long term follow-up results are comparable to conventional surgery. In India because of limited work load of colonic cancer, it has not made the progress unlike laparoscopic cholecystectomy. There are no large published series. We have carried out 32 colonic surgeries, out of which only six are for malignancy, the rest being inflammatory colonic diseases.
It makes great sense to offer the benefits : -
* Less post operative pain and analgesics.
* Shorter hospital stay.
* Less wound related and post-op pulmonary complication.
* Early return to work or family.
* Better cosmesis.
Diagnostic laparoscopy
1. This is offered to stage a malignant condition, take tissue for biopsy and have relook (second look) operation by laparoscopy. 2. To obtain specimen and lymph nodes in inflammatory large bowel diseases.
Laparoscopic colostomy
Laparoscopy is mainly used to achieve faecal diversion in unresectable malignant growth, severe perianal infections, trauma faecal incontinence and complex fistula in ano. If indicated even a loop iliostomy can be offered to patient.
Laparoscopic colonic resection
Rt and Lt hemicolectomy, total colonic resection, abdomino-perineal resection (APR), anterior resection (AR), lap assisted resection are various procedures that can be offered to patients. Out of these the most difficult technique is a transverse colonic resection in an obese patient. Large malignant and inflammatory masses also are relative contraindication for surgery. Obstructed lesions are absolute contraindication for Lap surgery. To resect the bowel Endo-staplers can be used. Now we have even smaller stapler in the form to endo G.I.A.
Complication of lap colonic surgery are the same as conventional surgery namely : -
* Bleeding.
* Anastomotic leak.
* Infection.
It has been observed that bowel function returns much earlier in lap surgery. Thus feeding is started much earlier and hospital stay is shorter. The reason for early return of peristaltic activity is lack of handling and non-exposure to outside atmospheric air. Flatus, faeces and feeds of colonic surgery are much faster in M.I.S.
Dissection of specimen removed after laparoscopy have been compared with conventional surgery specimen in terms of
* Number of lymph node harvested.
* Resected margin clearance.
* Length of specimen.
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