Laparoscopic Lower Anterior Resection
Laparoscopic Abdominoperineal Resection
Laparoscopic Total Mesorectal Resection
Right
Hemicolectomy
Hemicolectomy
Left
Hemicolectomy
Hemicolectomy
Laparoscopic Lower Anterior Resection
Laparoscopic Lower Anterior Resection
Overview
A low anterior resection (LAR) is the surgical procedure done for high rectal cancer. This procedure involves the removal of the cancer-ridden part of the rectum and restructuring of the remaining colon to allow normal bowel movements. It is a sphincter-sparing procedure.
Indications
This surgery is done for rectal cancer. While radiation and chemotherapy are often part of the treatment plan, surgery is generally advised. The type of surgical procedure depends on the location and stage of the cancer, but a low anterior resection (LAR) can be done for upper and mid rectal tumours. This type of colon rection surgery is commonly used in treating state3 2 and 3 rectal tumors, and in rare cases, state 1 tumors.
What happens during a laparoscopic lower anterior resection?
A low anterior resection is done with general anesthesia. Since this surgery is done laparoscopically, there will be no need for large incisions. Instead, only small [uncture-like incisions will be made in the lower abdomen. From there Dr Heyns will insert a thin tube-like surgical tool known as a laparoscopic. This laparoscope is fitted with a light and camera to allow for visualization of the internal organs. These images will show Dr Heyns the internal organ on a monitor while he performs surgery. During a low anterior resection (LAR) the part of the rectum containing the tumor is removed along with a small margin of the surrounding tissue. Thereafter the remaining part of health rectum anastomosed to the colon to restore normal bowel functioning and bowel movements.
■ YouTube video: Laparoscopic low anterior resection by Dr Heyns
Sometimes a temporary colostomy or ileostomy needs to be created, to minimize anastomotic leaks. This requires a small incision being made through the skin of the abdomen. Through this opening (stoma) the colon is connected to a bag on the outside of the body so that waste can be removed from the body. This is generally temporary and once healing is complete this surgery is reversed normal bowel moments are restored.
■ YouTube video: Laparoscopic low anterior resection by Dr Heyns
Sometimes a temporary colostomy or ileostomy needs to be created, to minimize anastomotic leaks. This requires a small incision being made through the skin of the abdomen. Through this opening (stoma) the colon is connected to a bag on the outside of the body so that waste can be removed from the body. This is generally temporary and once healing is complete this surgery is reversed normal bowel moments are restored.
What to expect after surgery
Upon waking from surgery, you can expect some pain near the incisions. If a temporary colostomy or Ileostomy were placed to aid healing, the stoma will be reversed, about 8 weeks later. Depending on how the surgery was done and the overall health os the patient, recovery may take 3 to 6 weeks. Depending on your treatment plan, radiation and chemotherapy may be necessary after surgery.
Laparoscopic Abdominoperineal Resection
Laparoscopic Abdominoperineal Resection
Overview
An abdominoperineal resection is a surgery in which the anus, rectum, and sigmoid colon are removed, and a permanent colostomy is placed.
The image here shows what a laparoscopic abdominoperineal resection involves.
Indications
This surgery is usually done as treatment for cancer located low in the rectum, in the anus or close to the sphincter muscles.
What happens during a laparoscopic abdominoperineal resection?
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 close the incision.
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 close the incision.
What to expect after surgery
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 some 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 has a team of knowledgeable stoma Sisto's that will contact you before the surgery. They will mark the stoma site and will help and train you in becoming comfortable with your stoma.
Laparoscopic Total Mesorectal Resection
Laparoscopic Total Mesorectal Resection
Overview
A total mesorectal excision is a procedure used in the treatment of colorectal cancer in which a significant length if the bowel around the tumor as well as surrounding tissue are removed. Dr Heyns will generally choose a laparoscopic approach using keyhole techniques when possible as this approach is minimally invasive.
Indications
A total mesorectal excision is considered the gold standard for tumors of the middle and lower rectum. It is a sphincter sparing surgery and entails the removal of the rectum, with the sigmoid colon, inholding the blood supply and associated lymph glands. Some-times a temporary ileostomy will be performed that will be reversed in 6-8 weeks after the surgery.
What happens during a total mesorectal excision?
This surgery is performed under general anaesthesia using laparoscopic techniques when possible. By making a few small incisions, a laparoscope can be inserted. With a camera and light at the end of it, this tool is used to view the abdominal cavity and organs, aiding surgery. While watching the video on a monitor, Dr Heyns can insert small surgical tools and remove the diseased rectum and part of the colon above it.
The fatty tissue that carries the blood vessels and lymph drainage to the bowel are also removed along with the nearby lymph nodes. The remaining ends of the bowel are then anastomised. If the ends cannot be reattached, a colostomy will be performed. A colostomy is done by creating an opening in the abdomen, called a stoma, so that the colon can be connected. Waste can then pass through the stoma to the outside of the body to a pouch where it can collect and be removed.
The fatty tissue that carries the blood vessels and lymph drainage to the bowel are also removed along with the nearby lymph nodes. The remaining ends of the bowel are then anastomised. If the ends cannot be reattached, a colostomy will be performed. A colostomy is done by creating an opening in the abdomen, called a stoma, so that the colon can be connected. Waste can then pass through the stoma to the outside of the body to a pouch where it can collect and be removed.
What to expect after surgery
Some pain and discomfort can be expected after a major surgery such as this. Pain relieving medications will be prescribed by Dr Heyns to make you comfortable and you will need to stay in hospital for the next week for observation. Once discharged you will need to rest and refrain from any heavy lifting for the next few weeks.
The images & video below show what a total mesorectal excision involves & how it is done
■ YouTube video: TME (total mesorectal excision) by Dr Heyns
The images & video below show what a total mesorectal excision involves & how it is done
■ YouTube video: TME (total mesorectal excision) by Dr Heyns
Right
Hemicolectomy
Hemicolectomy
Right Hemicolectomy
Overview
A right hemicolectomy is done to remove a tumour located on the right side of the colon, and attaching the small intestine to the remaining portion of the colon to restore functioning of the bowel. Dr Heyns is a general surgeon with a particular interest in laparoscopic colorectal surgeries so when possible, this surgery will be performed using keyhole techniques.
Indications
This surgery is done as the primary treatment for right sided colon cancer. Radiation and chemotherapy are often part of the treatment plan but surgery is generally advised.
While a right hemicolectomy is generally done for colon cancer, it may also be done for treatment of inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease, as well as benign polyps.
While a right hemicolectomy is generally done for colon cancer, it may also be done for treatment of inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease, as well as benign polyps.
What happens during a right hemicolectomy?
A right hemicolectomy is performed under general anaesthesia using laparoscopic techniques when possible. A few small incisions are made into the lower left side of your abdomen and a thin tube-like instrument, a laparoscope, is inserted into the incision. The laparoscope is fitted with a light and camera and will allow Dr Heyns to view inside the abdomen without the need for larger incisions. Through the trocars surgical tools are inserted and the cecum, ascending colon along with a small margin of the surrounding tissue, and the nearby lymph nodes are removed. An anastomosis is then done to join the remaining healthy ends of the large intestine with the small intestine.
The images below show what a Right Hemicolectomy involves.
Whether you have open or laparoscopic surgery will depend on many aspects. If surgery cannot be performed laparoscopically, an "open" operation may be done through a larger incision into the abdomen.
What to expect after surgery
You can expect some pain near the incisions when waking from anaesthesia. Pain medication will be prescribed. Once home, you will need to rest and avoid heavy lifting for another 2-3 weeks. Depending on how the surgery was done, recovery may take 3 to 6 weeks.
If surgery was done for treatment of colon cancer, radiation and chemotherapy may be necessary after surgery.
If surgery was done for treatment of colon cancer, radiation and chemotherapy may be necessary after surgery.
Left
Hemicolectomy
Hemicolectomy
Left Hemicolectomy
Overview
A left hemicolectomy is done to remove the descending colon or the left side of the colon. This is the part of your colon that's attached to your rectum. After it's removed, the remaining, transverse colon is reattached directly to your rectum to restore normal bowel functioning. This surgery is generally performed laparoscopically, which is the minimally invasive option.
Indications
This surgery is done as the primary treatment for tumours located in the left side of the colon. A left hemicolectomy may be performed for patients with colon cancer or for certain non-cancerous conditions such as Crohn's disease or diverticular disease. For those with colon cancer, radiation and chemotherapy are often part of the treatment plan but surgery plays a vital role.
What happens during a left hemicolectomy?
A left hemicolectomy is performed under general anesthesia. In most cases the operation can be performed via a laparoscopic (keyhole) surgical technique, but may also be done through traditional open surgery. During laparoscopic surgery, small puncture-like incisions are made in the abdomen through which a laparoscope is inserted. Since this tool has a camera and light fitted at the end of it, Dr Heyns is given better visualization of the operative area. Through other small incisions, surgical tools are inserted to resect the left side of the colon. This involves taking away the blood vessels and lymph nodes to that part of the bowel. The surgeon then rejoins (anastomose) the remaining colon to the top of the rectum.
If surgery cannot be performed through "keyhole" surgery, a larger incision will be made into the abdomen and traditional open surgery will be done.
If surgery cannot be performed through "keyhole" surgery, a larger incision will be made into the abdomen and traditional open surgery will be done.
What to expect after surgery
Pain and discomfort can be expected after waking from surgery. You will need to stay in hospital for two weeks before being discharged. Once home you will need to rest and Dr Heyns will give you instructions for your activity and restrictions thereof.
Click on the sections here above for more details
Laparoscopic Lower Anterior Resection
Overview
A low anterior resection (LAR) is the surgical procedure done for high rectal cancer. This procedure involves the removal of the cancer-ridden part of the rectum and restructuring of the remaining colon to allow normal bowel movements. It is a sphincter-sparing procedure.
Indications
This surgery is done for rectal cancer. While radiation and chemotherapy are often part of the treatment plan, surgery is generally advised. The type of surgical procedure depends on the location and stage of the cancer, but a low anterior resection (LAR) can be done for upper and mid rectal tumours. This type of colon rection surgery is commonly used in treating state3 2 and 3 rectal tumors, and in rare cases, state 1 tumors.
What happens during a laparoscopic lower anterior resection?
A low anterior resection is done with general anesthesia. Since this surgery is done laparoscopically, there will be no need for large incisions. Instead, only small [uncture-like incisions will be made in the lower abdomen. From there Dr Heyns will insert a thin tube-like surgical tool known as a laparoscopic. This laparoscope is fitted with a light and camera to allow for visualization of the internal organs. These images will show Dr Heyns the internal organ on a monitor while he performs surgery. During a low anterior resection (LAR) the part of the rectum containing the tumor is removed along with a small margin of the surrounding tissue. Thereafter the remaining part of health rectum anastomosed to the colon to restore normal bowel functioning and bowel movements.
■ YouTube video: Laparoscopic low anterior resection by Dr Heyns
Sometimes a temporary colostomy or ileostomy needs to be created, to minimize anastomotic leaks. This requires a small incision being made through the skin of the abdomen. Through this opening (stoma) the colon is connected to a bag on the outside of the body so that waste can be removed from the body. This is generally temporary and once healing is complete this surgery is reversed normal bowel moments are restored.
■ YouTube video: Laparoscopic low anterior resection by Dr Heyns
Sometimes a temporary colostomy or ileostomy needs to be created, to minimize anastomotic leaks. This requires a small incision being made through the skin of the abdomen. Through this opening (stoma) the colon is connected to a bag on the outside of the body so that waste can be removed from the body. This is generally temporary and once healing is complete this surgery is reversed normal bowel moments are restored.
What to expect after surgery
Upon waking from surgery, you can expect some pain near the incisions. If a temporary colostomy or Ileostomy were placed to aid healing, the stoma will be reversed, about 8 weeks later. Depending on how the surgery was done and the overall health os the patient, recovery may take 3 to 6 weeks. Depending on your treatment plan, radiation and chemotherapy may be necessary after surgery.
Laparoscopic Abdominoperineal Resection
Overview
An abdominoperineal resection is a surgery in which the anus, rectum, and sigmoid colon are removed, and a permanent colostomy is placed.
The image here shows what a laparoscopic abdominoperineal resection involves.
Indications
This surgery is usually done as treatment for cancer located low in the rectum, in the anus or close to the sphincter muscles.
What happens during a laparoscopic abdominoperineal resection?
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 close the incision.
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 close the incision.
What to expect after surgery
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 some 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 has a team of knowledgeable stoma Sisto's that will contact you before the surgery. They will mark the stoma site and will help and train you in becoming comfortable with your stoma.
Laparoscopic Total Mesorectal Resection
Overview
A total mesorectal excision is a procedure used in the treatment of colorectal cancer in which a significant length if the bowel around the tumor as well as surrounding tissue are removed. Dr Heyns will generally choose a laparoscopic approach using keyhole techniques when possible as this approach is minimally invasive.
Indications
A total mesorectal excision is considered the gold standard for tumors of the middle and lower rectum. It is a sphincter sparing surgery and entails the removal of the rectum, with the sigmoid colon, inholding the blood supply and associated lymph glands. Some-times a temporary ileostomy will be performed that will be reversed in 6-8 weeks after the surgery.
What happens during a total mesorectal excision?
This surgery is performed under general anaesthesia using laparoscopic techniques when possible. By making a few small incisions, a laparoscope can be inserted. With a camera and light at the end of it, this tool is used to view the abdominal cavity and organs, aiding surgery. While watching the video on a monitor, Dr Heyns can insert small surgical tools and remove the diseased rectum and part of the colon above it.
The fatty tissue that carries the blood vessels and lymph drainage to the bowel are also removed along with the nearby lymph nodes. The remaining ends of the bowel are then anastomised. If the ends cannot be reattached, a colostomy will be performed. A colostomy is done by creating an opening in the abdomen, called a stoma, so that the colon can be connected. Waste can then pass through the stoma to the outside of the body to a pouch where it can collect and be removed.
The fatty tissue that carries the blood vessels and lymph drainage to the bowel are also removed along with the nearby lymph nodes. The remaining ends of the bowel are then anastomised. If the ends cannot be reattached, a colostomy will be performed. A colostomy is done by creating an opening in the abdomen, called a stoma, so that the colon can be connected. Waste can then pass through the stoma to the outside of the body to a pouch where it can collect and be removed.
What to expect after surgery
Some pain and discomfort can be expected after a major surgery such as this. Pain relieving medications will be prescribed by Dr Heyns to make you comfortable and you will need to stay in hospital for the next week for observation. Once discharged you will need to rest and refrain from any heavy lifting for the next few weeks.
The images & video below show what a total mesorectal excision involves & how it is done
■ YouTube video: TME (total mesorectal excision) by Dr Heyns
The images & video below show what a total mesorectal excision involves & how it is done
■ YouTube video: TME (total mesorectal excision) by Dr Heyns
Right Hemicolectomy
Overview
A right hemicolectomy is done to remove a tumour located on the right side of the colon, and attaching the small intestine to the remaining portion of the colon to restore functioning of the bowel. Dr Heyns is a general surgeon with a particular interest in laparoscopic colorectal surgeries so when possible, this surgery will be performed using keyhole techniques.
Indications
This surgery is done as the primary treatment for right sided colon cancer. Radiation and chemotherapy are often part of the treatment plan but surgery is generally advised.
While a right hemicolectomy is generally done for colon cancer, it may also be done for treatment of inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease, as well as benign polyps.
While a right hemicolectomy is generally done for colon cancer, it may also be done for treatment of inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease, as well as benign polyps.
What happens during a right hemicolectomy?
A right hemicolectomy is performed under general anaesthesia using laparoscopic techniques when possible. A few small incisions are made into the lower left side of your abdomen and a thin tube-like instrument, a laparoscope, is inserted into the incision. The laparoscope is fitted with a light and camera and will allow Dr Heyns to view inside the abdomen without the need for larger incisions. Through the trocars surgical tools are inserted and the cecum, ascending colon along with a small margin of the surrounding tissue, and the nearby lymph nodes are removed. An anastomosis is then done to join the remaining healthy ends of the large intestine with the small intestine.
The images below show what a Right Hemicolectomy involves.
Whether you have open or laparoscopic surgery will depend on many aspects. If surgery cannot be performed laparoscopically, an "open" operation may be done through a larger incision into the abdomen.
What to expect after surgery
You can expect some pain near the incisions when waking from anaesthesia. Pain medication will be prescribed. Once home, you will need to rest and avoid heavy lifting for another 2-3 weeks. Depending on how the surgery was done, recovery may take 3 to 6 weeks.
If surgery was done for treatment of colon cancer, radiation and chemotherapy may be necessary after surgery.
If surgery was done for treatment of colon cancer, radiation and chemotherapy may be necessary after surgery.
Left Hemicolectomy
Overview
A left hemicolectomy is done to remove the descending colon or the left side of the colon. This is the part of your colon that's attached to your rectum. After it's removed, the remaining, transverse colon is reattached directly to your rectum to restore normal bowel functioning. This surgery is generally performed laparoscopically, which is the minimally invasive option.
Indications
This surgery is done as the primary treatment for tumours located in the left side of the colon. A left hemicolectomy may be performed for patients with colon cancer or for certain non-cancerous conditions such as Crohn's disease or diverticular disease. For those with colon cancer, radiation and chemotherapy are often part of the treatment plan but surgery plays a vital role.
What happens during a left hemicolectomy?
A left hemicolectomy is performed under general anesthesia. In most cases the operation can be performed via a laparoscopic (keyhole) surgical technique, but may also be done through traditional open surgery. During laparoscopic surgery, small puncture-like incisions are made in the abdomen through which a laparoscope is inserted. Since this tool has a camera and light fitted at the end of it, Dr Heyns is given better visualization of the operative area. Through other small incisions, surgical tools are inserted to resect the left side of the colon. This involves taking away the blood vessels and lymph nodes to that part of the bowel. The surgeon then rejoins (anastomose) the remaining colon to the top of the rectum.
If surgery cannot be performed through "keyhole" surgery, a larger incision will be made into the abdomen and traditional open surgery will be done.
If surgery cannot be performed through "keyhole" surgery, a larger incision will be made into the abdomen and traditional open surgery will be done.
What to expect after surgery
Pain and discomfort can be expected after waking from surgery. You will need to stay in hospital for two weeks before being discharged. Once home you will need to rest and Dr Heyns will give you instructions for your activity and restrictions thereof.