Mr. Thomas Francis Greene, ARNP, FNP

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.

When excessive sweating is the main complaint and is not related to any other condition, it is called primary hyperhidrosis. There is no known cause, but it does tend to run in families. Secondary hyperhidrosis is sweating that is caused by another medical condition, such as anxiety, cancer, hyperthyroidism, or menopause. Sometimes treating the underlying condition can improve this type of sweating.

There are tests doctors can use to diagnose hyperhidrosis. One involves simply soaking up the perspiration with paper and then weighing the paper to measure how much extra sweat is being produced. Another test, called the starch-iodine test, involves covering the body with powder. This powder turns blue in any areas where sweat is produced.

Treatment depends on the severity of the hyperhidrosis and the areas affected. Some options are:

• Prescription antiperspirants, which contain aluminum chloride and work by plugging the sweat ducts. This signals the sweat glands to decrease sweat production. They work for moderate cases of hyperhidrosis and are relatively affordable.
• Lontophoresis, a procedure that uses small amounts of electricity and a tray of tap water to decrease production of sweat glands in the hands or feet.
• Botox, which can be injected into the nerves that control sweat glands in the underarms.
• Sympathectomy, a surgery for severe cases that can be performed to cut the nerves that stimulate sweat production. Sympathectomy is most effective for hyperhidrosis of the hands. It may cause new symptoms of sweating elsewhere on the body.
• Surgery to remove sweat glands, most often in the underarms.

Hyperhidrosis is a serious medical condition that causes both physical and emotional distress. Treatments are available, and support groups exist to help patients cope.

Pancreatectomy can be done by open or minimally invasive surgery. During a laparoscopic pancreatectomy, the surgeon will use tiny incisions to insert a thin tube with a camera, or laparoscope, into the abdomen. Open surgery, or a laparotomy, is performed through a larger incision on the abdomen. If additional organs are removed, some procedures may require that the small intestine be reconnected to the stomach.

The hospital for pancreatectomy stay may be between 1-3 weeks. Generally, laparoscopic surgeries require shorter recovery periods. Whether patients undergo an open or laparoscopic procedure is determined by factors such as their condition and the extent of their procedure. For example, open surgery tends to be more common for distal pancreatectomies. If patients have difficulty eating, they may require a nasogastric tube, inserted through the nose, to carry food to their stomachs. A catheter can be inserted into the bladder if patients have trouble urinating. Full recovery may take about two months.