Dr. Mark Reeves, PhD, MD

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.

Liver resection can be performed laparoscopically or through open surgery. Laparoscopic liver resection is a minimally invasive surgery that requires a few tiny incisions on the abdomen, through which the surgeon inserts a thin tube with a camera (laparoscope). Open hepatectomy is performed through a laparotomy, which makes one large incision on the abdomen. Although a laparoscopic liver resection is associated with less pain and quicker recovery, patients may have to undergo an open liver resection depending on factors such as the location of the tumor and previous abdominal operations they have had.

After the liver resection, patients will stay in the hospital for up to six days. The recovery period will vary based on how much of the liver was removed. Limiting consumption of alcohol and light physical activity, such as walking, can help patients to have a speedy recovery.

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.