Colonoscopy and Colon surgery

Colonoscopy - This is the test to diagnose any possible large intestinal issues including cancer. The procedure is done under sedation and after the patient cleans the intestines with an oral  laxative given by prescription to be taken the night before. The current standard recommendation is that everyone gets the test done at the age of 50 and then every 10 years if normal. If polyps are removed (small growths) or any other abnormality is found then the interval will be shorten to 1-5 years depending on the finding. This is a painless procedure and the patient can resume normal activity immediately after. If a person has family history of colon cancer then the screenings should begin in the fourth decade instead of 50. Also if a patient comes with rectal bleeding or other symptoms that suggest colon disease, then a colonoscopy should be consider regardless of age or history.

The risks involved are bleeding, and perforation. Bleeding can occur from a site where a polyp removal is done or from a biopsy site and perforation from a biopsy, removal or from pushing through the intestinal wall. Usually these are rare complications but can occur. In the hands of a surgeon these are handle as they are recognized and fixed expeditiously. Colonoscopy is the best way to prevent and diagnose colon cancer.

Colon Surgery - The colon has four main sections and they are separate from the rectum. These are the right or ascending colon, transverse colon, descending colon and sigmoid colon. See the picture below and the labels.

When we identify pathology in a section of the colon then we plan a surgical intervention. The main causes of surgical intervention are diverticular disease and tumors or large polyps. The options now a day are the traditional open surgery, laparoscopic surgery or robotically assisted laparoscopic surgery. The last two are the most common and better known as minimally invasive surgery which allow for a faster recovery and smaller incisions. Now a days we can do surgery and a patient is discharged anywhere from 1-5 days with smaller incisions and quick recovery. Each patient is different and has a different expected recovery depending on many factors like age and other medical conditions.

The risks of colon surgery are inherent to the mechanics involved in resecting in a bacteria rich organ as is the colon, and when creating an anastomosis or connection between the to healthy ends.  The risks are infection, leakage of the anastomosis, bleeding, recurrence of the cancer or tumor, need for more surgery damage to surrounding structures or organs inadvertently due to low visibility.

For these and other reasons we provide the patient with instructions and the necessary medications and antibiotics to perform a preoperative bowel preparation the night before surgery.

 During the surgical consultation we go over all these and many other details regarding the procedure and the process and specific to each patient.