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Laparoscopic Anterior Resection of the Rectum and Sigmoid Colon

Pre-operative Preparation for a Laparoscopic Anterior Resection of the Rectum and Sigmoid Colon procedure

There is some important information about the pre-operative preparation for this procedure. It is imperative that you read this.

Read about Bowel Pre-operative Preparation

The Procedure

About Laparoscopic Anterior Resection of the rectum and sigmoid colon

It is an operation to surgically remove the rectum via the abdomen and to restore continuity of the bowel. The rectum and sigmoid colon is the last part of the gut, just before it becomes the anus. It passes down through the pelvis and in so doing is attached to the side walls of the pelvis and the other organs within the pelvis, namely bladder and ureters (tubes that carry urine from the kidneys to the bladder), pelvic nerves, uterus and vagina in females, and prostate gland and seminal vesicles in males.

Indications

The operation is usually performed to remove a cancer (malignant tumour or large benign polyp within the rectum/sigmoid colon). A laparoscopic high anterior resection is a variation on the theme and is done to remove predominantly the sigmoid colon but also a variable amount of descending colon, usually for diverticular disease that cannot be controlled by conservative measures. The first part of the rectum is also removed to ensure that the whole of the sigmoid colon has been completely removed and the join up (anastomosis) is on to a part of the rectum that has an excellent blood supply.

Anaesthesia and antibiotics

The operation will be performed under a general anaesthetic, administered by an anaesthetist. Antibiotics will be given in the operating room.

Operative procedure

The bowel will be operated on using keyhole surgery through several small incisions made in the abdomen. The operation involves separating the rectum and colon, and its surrounding lymph nodes, from adjacent structures, whilst taking great care to protect and preserve the latter. The rectum is cut across below the tumour (to include a safe margin of healthy tissue), and the colon is cut upstream of the rectum. The final part of the operation is to join (an anastomosis) the cut ends to restore continuity of the bowel. This is done with a single-use (disposable) device which places a double row of titanium (inert) staples around the circumference of the bowel. Occasionally sutures are placed by hand instead of or as well as staples.

Colostomy

You may require a temporary colostomy or ileostomy (bag) at the time of operation if your surgeon deems this to be appropriate. He will discuss the reasons for doing this at your consultation.

Laparoscopic high anterior resection Sigmoid colon and proximal rectum


Post-operative Care following a Laparoscopic Anterior Resection of the Rectum and Sigmoid Colon procedure

There is some very useful information regarding your care following this procedure and it is important that you take time to read it.

Read about Bowel Post-operative Care

Related Information

Read about Colon Cancer
Read about Diverticular Disease
Read about Rectal Cancer
Read about Laparoscopy