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Following removal of the bowel segment, the surgeon may restore continuity of the bowel or create a colostomy. Partial or subtotal colectomy refers to removing a portion of the colon, while total colectomy involves the removal of the entire colon.
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]
Panniculectomy is the removal of a panniculus, which is a dense layer of fatty tissue growth consisting of subcutaneous fat in the lower abdominal area. Parathyroidectomy is the surgical removal of one or more of the parathyroid glands. Penectomy is the partial or complete removal of the penis. Also known as a pendectomy.
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 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.
Only the proximal stoma is functioning. Most often, double-barrel colostomy is a temporary colostomy with two openings into the colon (distal and proximal). The elimination occurs through the proximal stoma. Colostomy surgery that is planned usually has a higher rate of long-term success than surgery performed in an emergency situation.
[5] [6] The operation can be done by open surgery, laparoscopic or Robot-assisted. [7] For lower down tumours in the middle and lower third of the rectum a new procedure has been developed known as Transanal-Total Mesorectal Excision (TaTME). Instead of the dissection via the abdomen TaTME combines an abdominal and transanal endoscopic approach ...
The surgical procedure is typically done in two stages, but it is possible to conduct the surgery in one stage. The first stage is the discontinuation of the waste functions by performing a colostomy and ileal conduit in the upper abdominal quadrants. The second stage is the amputation at the lumbar spine. [5] [6]