Colon disease is quite common today, with more than 500,000 colon surgeries performed on adult patients in the United States on a yearly basis. The most common reasons for colon surgery include colon cancer, diverticular disease, gastrointestinal bleeding, inflammatory bowel diseases like Crohn's disease, intestinal polyps, large bowel obstruction, trauma, and bowel rupture. There are 2 options for colon surgery: laparoscopic surgery or open surgery. The doctor considers each patient's diagnosis and state of health to determine which approach will be best for them.
In open colon surgery, the doctor usually creates an abdominal incision called a laparotomy. This incision allows for direct access to the entire colon. Part or all of the colon can be removed through this incision, based on the patient's condition and needs.
While open colon surgery is still considered the "traditional" approach, laparoscopic colon surgery is becoming increasingly common, because this surgery allows for faster patient recovery. In this procedure, several tiny incisions are created in the abdomen. Specialized surgical instruments are then inserted into these incisions to remove a portion of the colon.
In a right hemicolectomy, the ascending part of the colon is resectioned. In a left hemicolectomy, the descending part of the colon is resectioned. If a portion of the transverse colon is also resectioned, the procedure is called an extended hemicolectomy. A transverse colectomy is an uncommon technique in which the transverse colon running across the pelvic area is resectioned. In a sigmoidectomy, the sigmoid colon is resectioned. This can include some or all of the rectum. When a terminal colostomy and the closure of the rectal stump are done after a sigmoidectomy, the procedure is called Hartmann's operation. In a total colectomy, the entire colon is removed. If the rectum is completely removed at the same time, the procedure is known as a total proctocolectomy. In a subtotal colectomy, part or all of the colon is resectioned, but the rectum is not.
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