The surgical procedure to remove the colon, rectum, and anus is known as a total proctocolectomy. This surgical procedure is generally performed when the patient is under the influence of general anesthesia. The reason you may need to undergo this procedure can be inflammatory bowel disease that has failed to respond to other medical treatments. Severe intestinal damage due to inflammation is another reason you may need this procedure.
After this procedure, your body will need a way to eliminate wastes. That is why the surgeon will bring the end of the small intestinal out through the abdominal wall to create a stoma. After surgery, you will need to wear an ostomy bag over the stoma to manage your waste evacuations.
Reasons you may need this surgery
If your inflammatory bowel disease has failed to respond to medications, your doctor will consider a proctocolectomy as the last resort. Surgeons usually try ways to save the rectum and anus during surgery.
You may also need this procedure due to the colon or rectal cancer. Doctors refer a patient to surgeons if the colon or rectum is damaged beyond repair.
Preparing for surgery
Your doctor will schedule this surgery several weeks in advance to help you prepare for it. During this preparation time, you will have to adjust to a more restricted diet and activity routine. For instance, you may have to eat a high-fiber diet and drink plenty of water a day. The purpose of this diet plan is to keep you hydrated and help your intestines function normally.
During this time, you have to refrain from eating or drinking anything at midnight. The surgeon will also ask you to clean your bowels regularly through an enema. He will ask you to take laxatives before surgery to clean your bowels. It is called bowel prep. This step results in diarrhea and mild cramping for a few hours.
Surgical procedure and aftercare
The surgical team will administer general anesthesia before starting the operation. It will put you to sleep for the entire duration of the surgery. As a result, you won’t feel any pain during surgery.
Surgeons prefer a laparoscopic procedure, which is less invasive. This procedure involves the insertion of a small camera through one of the several small incisions that your surgeon makes on the abdominal wall. This camera allows the surgical team to monitor the process. Other incisions will be used to insert small tools to operate.
The second method is open surgery, in which the surgeon makes one large incision on the abdomen. It allows the surgical team to access your entire intestinal tract. It is a more invasive type of surgery compared to the laparoscopic procedure. The surgeon will choose to perform this surgery if he suspects the spread of cancer to the other organs.
During surgery, the surgeon will disconnect the small bowel from the colon and bring the end of the small bowel to the outside of the body through a small incision in the abdominal wall. It will create a stoma, which helps the body to expel bodily wastes.
After surgery, you will need to take care of your ileostomy by wearing a properly fitting ostomy bag over the stoma. You will need to avoid the contact of waste materials with the skin around the stoma to prevent any peristomal complications. You can learn about the complications and their solutions from your doctor or ostomy care nurse.
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