An abdominoperineal resection is a surgery in which the anus, rectum, and sigmoid colon are removed.
This surgery is usually done as treatment for cancer located low in the rectum, in the anus or close to the sphincter muscles.
An abdominoperineal resection is usually performed by Dr Heyns using a minimally invasive surgical technique known as laparoscopy or "keyhole" surgery, which enables the surgeon to complete the surgery through very small keyhole-sized incisions in the abdomen. A laparoscope, which is a small, telescope-like instrument, is then placed through an incision. With the light and camera that is attached to this tool, Dr Heyns is able to visualize the internal cavity while operating. Images taken by the laparoscope will be projected onto video monitors placed near the operating table. More small surgical tools are then inserted to carefully cut and close the main blood vessels that serve the diseased sections of the bowel before resecting the sigmoid colon from its supporting structures and dividing it from the remaining large intestine. Next, your surgeon will remove the rectum through incisions in the perineal region (the area between the legs).
Once the anus and rectum have been removed, a new opening through which waste can pass from the body will need to be created. This procedure may also be called a colostomy. The opening, called a "stoma", is made from the large intestine to the surface of the skin of the abdomen. The colon will then be pulled through this site to the surface of the skin and stitched in place. . Finally, your surgeon will carefully inspect the abdominal cavity and stitch the incisions closed.
You can expect some pain near the incisions when waking from anaesthesia. An external bag or pouch, known as a colostomy bag, will be attached to the opening to collect waste from the colon. Unlike your anus, the stoma has no sphincter muscles, so you will not be able to control the exit of waste. You will generally need to wear a pouch at all times to collect the waste flow. Dr Heyns will have a dietician accompany him when discussing the caring requirements and dietary restrictions needed for your colostomy bag – but you would have had a discussion about this before surgery as well.
The image below shows what a laparoscopic abdominoperineal resection involves.