Colon Cancer Surgery - Laparoscopic Colectomy

A colectomy is the medical term used to describe the procedure of removing either a part of, or the entire colon. Most commonly used to treat colon cancer, doctors also use colectomy to prevent and treat other diseases of the colon. As with most diseases, early identification and treatment of colon cancer means only minor surgery is likely to be required. In this case, doctors may need to remove only a small section of the colon. However, cancers that have already progressed to latter stages may require doctors to remove a larger section of the colon.

There are a few conditions that require a colon operation; examples of such conditions follow:

• Colon cancer
• Diverticulitis
• Inflammatory disease
• Crohn’s disease
• Ulcerative colitis

However, colon cancer is the most common disease requiring a colectomy. When the cancerous portion of the colon is removed, the lymphs surrounding it are removed as well, so that the cancer does not spread and the colon can be healthy again. 

Traditionally, the treatment for colon cancer has required an invasive abdominal incision of 8 to 12 inches long. This meant the patient would spend up to 2 weeks in hospital due to severe postoperative pain. This is followed by an extended recovery period before they can resume their regular activities. Contrarily, a laparoscopic colectomy is a minimally invasive procedure that results in reduced post-operative pain and a faster recovery time. In general, laparoscopic patients can return to their normal routine, including work, within just 1-2 weeks.

As a minimally invasive procedure, a laparoscopic colectomy is performed under general anesthesia. It generally only requires about 3-5 small incisions in total. Following the incisions, surgeons will then inflate the abdomen with carbon dioxide before inserting a compact 3D telescope. The use of the telescope is an invaluable tool for Samitivej’s surgical team. This is because it allows them to clearly see the inside of the abdomen on a 4K monitor. This state-of-the-art technology not only provides enhanced visualization, but it also allows for greater depth perception. With patient wellbeing as our top priority, our surgical team is now able to maximize the precision of the procedure and improve patient safety.

Prior to surgery, all patients are required to undergo a thorough physical examination. Hospitals conduct tests to check for any underlying medical conditions that may affect the procedure. If additional testing is required such as x-rays or blood tests, Samitivej staff will be on hand to assist. All patients are also required to disclose any current medications that they are taking. Some of the medications may thin the blood, hence doctors may recommend temporarily not taking them prior to surgery.

The day immediately prior to surgery, patients need to undergo a relatively simple procedure known as bowel preparation. The purpose of this is to clean all stool from the colon and to ensure it is ready for surgery. As with the rest of the procedure, a designated doctor or nurse will be on hand to provide guidance and further instructions. Finally, doctors will also ask patients not to eat or drink anything after midnight on the evening prior to surgery.

As a laparoscopic colectomy is performed under general anesthesia, patients will be unconscious for the duration of the procedure. After regaining consciousness, patients are likely to experience mild discomfort due to the tubing used to remove stomach secretions and urine from the bladder. These tubes will remain connected to the patient until stomach and bowel functions return to normal. This normally takes a few days. Directly following surgery, patients will be unable to consume any food or drink. However, as each day progresses, the patient’s ability to eat will return, and their diet will be altered accordingly.

Post-operative follow-up and patient care is extremely important to avoid any complications arising. We advise all patients to make an appointment with their surgeon approximately two weeks after their discharge from hospital. This consultation provides an opportunity to identify if patients require any further support. It also provides a chance for patients to receive formal clearance to return to work and to other daily activities such as driving or operating machinery.

Once you are at home, it is important to maintain a healthy lifestyle to prevent readmission. Doctors recommend that for two weeks following the operation, a low fiber diet is implemented to reduce frequent bowel movements. Drinking plenty of fluids is also highly recommended. A nutritionist will advise the best plan of action for you and your body.

Normal physical activity can, in most cases, resume within one to two weeks. You can return to work or school, but keep in mind that heavy lifting or undue strain should be avoided for four to six weeks after surgery.

It is important that your hands are completely clean, when touching the site of the surgery. This way, there is little risk of infection. Long amounts of time in the water are ill advised when the stitches are still in, as is exposure to the sun. Be gentle with the wound; it will typically heal in four to six weeks, and taking care not to aggravate the area aids in this recovery.

When to contact your surgeon

You should contact your surgeon if you are experiencing any of the following symptoms after surgery:

• Persistent or increasing pain
• A fever of more than 101 degrees F or 38.3 degrees C
• Persistent nausea and vomiting
• Swollen or painful abdomen
• Odorous discharge, redness, swelling or bleeding of the wound
• No bowel movements after two to three days following surgery

Colorectal Surgeons (Colorectal Surgery Specialists)

• Chingyiam Panjapiyakul, M.D.
• Apichart Thanapatcharoen, M.D.
• Wannaporn Teerasopon, M.D.
• Frcst, Facs, Fasmbs. Pornthep Prathanvanich, M.D.
• Pakpong Wathanaoran, M.D.

What are the costs for colon cancer surgery with laparoscopic colectomy and can my insurance cover this? Click here.

Catering to the international and local Thai communities, the Surgery Clinic at Samitivej, Bangkok adheres to the highest standards of quality. Led by a team of certified surgeons with years of combined experience, our clinic is proud to perform safe, effective operations for all who require them. We understand that finding the right surgeon is critical and ensure that we choose only the very best to work on our team. It is in acknowledgement of this commitment to excellence that our hospital has received the prestigious JCI accreditation, the highest recognition that an international hospital can obtain.

Samitivej has a team ready to help and provide services for:

• Treatment Plan Consultation with a doctor via online video-call (second opinion)
• Treatment Planning if you have medical records or a price estimate from another hospital
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)

• Online Consultation: Patients can consult a specialist doctor by submitting a medical report and participating in a video call regarding treatment plans via Samitivej Virtual Hospital.
• Samitivej PACE: The access link to this application will be sent to patients so they can forward it to their relatives to use for real-time monitoring during surgery. They can check the patient’s status at any time, for instance, while they are waiting to enter the operating room or patient recovery rooms.

• Samitivej PROMPT: This service is provided to patients to send a message to their doctor and choose the times of day during in which they do not wish to be disturbed. It also displays initial hospital bill.
• Online Follow-up Appointment: Patients may change their on-site follow-up appointment to a video call at the discretion of the doctor in charge of treatment.