Dr. Sherry Marie Wren, MD, FACS

A colectomy may be performed by laparoscopic or open surgery. A laparoscopic colectomy requires several small cuts on the abdomen, and uses a thin tube with a camera, called a laparoscope. Laparoscopic colectomies are less invasive than open procedures. For some individuals, a laparoscopic colectomy may not be possible, and instead an open colectomy is performed. In an open colectomy, a large incision is made on the abdomen. Open colectomies typically require longer recovery periods.

After the incisions are made, a portion of the colon is removed, and the remaining ends of the colon are attached to each other in a procedure called anastomosis. Waste can continue to travel through the body as normal. However, in some situations, it may be necessary for the end of the colon to be attached to an opening in the abdomen, called a stoma. This procedure is called an ostomy. Types of ostomies include:

• Colostomy, in which the remaining portion of the colon is attached to the abdominal opening.
• Ileostomy, in which the small intestine is attached to the abdominal opening.

An ostomy bag will be attached to the skin to collect waste. If the entire colon is removed, either an ileostomy is performed, or the small intestine is connected to the anus and waste may pass through as normal.

Stomas may be permanent or temporary. If the stoma is temporary, the ends of the colon will be rejoined in a later procedure. Temporary stomas are generally used to allow time for the colon to heal following surgery.

A colectomy may take between one and four hours. Following the procedure, patients will need to consume a liquid and low fiber diet before gradually returning to their normal diet. Patients will need to stay in the hospital for three to seven days for monitoring. Full recovery and return to normal activity may take anywhere from a few weeks to several months.

Today, most gallbladder surgeries are done laparoscopically. Four tiny incisions are made in the abdomen, and small tools are inserted through these tiny incisions to perform the surgery. Because the incisions are much smaller, recovery time is much faster with this type of surgery. Patients are usually discharged from the hospital the same day. Sometimes, open surgery is used to remove a gallbladder. In this type of surgery, a cut about six inches long is made in the upper right abdomen. After the gallbladder is removed, it is sutured or stapled closed. With open surgery, patients usually stay in the hospital for two to three days to recover before they are discharged.

Gallbladder removal, like any surgery, carries some risks, such as bleeding, infection, or the development of blood clots. Doctors will tell patients how to minimize their risk for complications. After surgery, patients are advised to avoid strenuous activity for several days. They should not soak in a bath until their sutures or staples have been removed. Patients should wash hands before touching the area around the incision. It will take a couple of days until patients feel like themselves again and a few weeks until their scar has healed and faded.

There are many benefits to robotic surgery, both for the patient and the surgeon. Robotic surgery allows for more precise movements and increased control during very delicate surgical procedures. This makes performing surgery accurately much easier for surgeons and reduces fatigue. The smaller 'hand' of the robot can enter the body via a much smaller opening, which reduces the risk of infection and scarring and leads to a faster recovery. The robotic hands also contain tiny moveable cameras among their tools, giving surgeons a much closer view of the procedure than would be possible with traditional surgery.