Laparoscopic Colorectal Surgery

It is now possible to safely and effectively remove sections of the colon (large intestine, large bowel), rectum, and small intestine (small bowel) using laparoscopic or minimally invasive techniques.

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Laparoscopic colorectal surgeryUsing advanced minimally invasive techniques, the surgeon can perform an operation that traditionally requires a large incision through 3 or 4 small incisions, usually less than half an inch each. This results in less pain, a shorter stay in the hospital, and faster return to normal activities such as work and exercise. There are now many scientific studies which confirm this (see references below). There may also be less stress to the immune system, and fewer complications, although these haven’t been studied as well.

 
These minimally invasive techniques are appropriate for a wide range of diseases, including colorectal cancer, diverticulitis, Crohn’s disease of the small and large intestines, ulcerative colitis, colon polyps, and many others. In fact, most colon resections can now be done using laparoscopic techniques.


Despite this fact, most colon operations are still performed using traditional open surgery. This is because laparoscopic bowel surgery requires advanced training, and many general surgeons do not perform enough colectomies to become proficient with these techniques. Dr. Begos, a board certified Colon and Rectal surgeon, and a Fellow of the American Society of Colon and Rectal Surgery, was fortunate to train with one of the pioneers of laparoscopic colon surgery, Garth Ballantyne, while he was a surgical resident at Yale. He spent one year working in Dr. Ballantyne’s lab, studying these advanced techniques, which were being developed at the time. In addition, Dr. Begos worked with Dr. Jeffery Milsom during his fellowship in Colorectal Surgery at the Cleveland Clinic. Dr. Milsom was also at the forefront of laparoscopic colon surgery, and remains a leader in the field.


Dr. Begos is also a recognized leader in the field of laparoscopic colon surgery. He has performed over 250 laparoscopic colon and rectal resections, and has published several papers on the topic in peer reviewed journals (see references below). In addition, he is involved in teaching and preceptoring other surgeons in minimally invasive bowel resection techniques, and has spoken on the topic at national and international meetings.
While not every patient is a candidate for this procedure, most are. If you require colon surgery, ask your doctor about the possibility of performing the procedure laparoscopically, and how many laparoscopic colectomies he or she has done. If you would like a second opinion regarding this option, please give Dr. Begos a call.


References and suggested reading:


1: Schadde E, Smith D, Alkoraishi AS, Begos DG.  
  Hand-assisted laparoscopic colorectal surgery (HALS) at a community hospital: a prospective analysis of 104 consecutive cases.
Surg Endosc. 2006 Jul;20(7):1077-82. Epub 2006 May 26.

2: Naar D, Begos DG, Alkoraishi AS.  
  Comparison of Hand Assisted vs Total laparoscopic Colectomy: A single surgeon’s experience.
Abstract, J Soc Laparoendoscopic Surgeons, 5 (4):380 December, 2001

3: Begos DG, Arsenault J, Ballantyne GH.  
  Laparoscopic colon and rectal surgery at a VA hospital. Analysis of the first 50 cases.
Surg Endosc. 1996 Nov;10(11):1050-6.

4: Begos DG, Ballantyne GH.  
  Laparoscopic Left Hemicolectomy and Anterior Resection.
in Laparoscopic Colorectal Surgery. Monson, J., Darcy, D., eds. Isis Medical Media Ltd. Oxford, England, 1995; 11 38.

5: Modlin IM, Begos DG, Ballantyne GH.  
  Laparoscopic Gastrointestinal Surgery: Current State of the Art.
Supplement to Clinical Gastroenterology Howard Spiro, editor. McGraw Hill, 1994; 1 22.

6: Begos DG, Arsenault J, Ballantyne GH.  
  Laparoscopic colon and rectal surgery at a VA hospital. Analysis of the first 50 cases.
Surg Endosc. 1996 Nov;10(11):1050-6.
PMID: 8881050 [PubMed - indexed for MEDLINE

7: Bruch HP, Esnaashari H, Schwandner O.  
  Current status of laparoscopic therapy of colorectal cancer.
Dig Dis. 2005;23(2):127-34. Review.

8: Schwenk W, Haase O, Neudecker J, Muller JM.  
  Short term benefits for laparoscopic colorectal resection.
Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003145. Review.