Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes the inner lining of the large intestine (colon) and rectum to become inflamed. The inflammation starts in the rectum and moves up through the colon. Ulcerative colitis affects the functioning of the intestine and causes symptoms such as fatigue, rectal bleeding, diarrhea and abdominal pain. Surgery is required to treat the condition if it does not improve with medications or develop complications. Surgery can be performed either with an open approach or a laparoscopic approach. Laparoscopic surgery is a minimally invasive procedure which involves the use of specialized instruments and a tiny video camera to treat ulcerative colitis.
Laparoscopic surgery is indicated to treat severe or sudden ulcerative colitis that does not respond to medications or if the inflammation is localized in a specific part of the colon.
The surgery is performed under the effect of general anesthesia. A small port is inserted into your abdominal cavity and carbon-dioxide gas is passed for inflating the cavity to increase the visibility of internal organs. Your surgeon will insert a laparoscope (thin flexible tube attached to a video camera and a light source) through this port and make additional small incisions for inserting specialized instruments. Proctocolectomy (removal of the colon and rectum) with ileoanal anastomosis or proctocolectomy with ileostomy is performed using the laparoscopic approach. After the procedure, the instruments are removed and incisions are closed.
- Ileoanal anastomosis: involves attaching the ileum to the inside of the rectum to create a pouch. Waste material collected in the pouch is excreted directly through the anus.
- Ileostomy: involves attaching the ileum to an opening in the abdomen called a stoma. Waste material is collected into an external pouch which is placed over the stoma.
After the laparoscopic procedure, medications are administered to relieve pain. It is advised to start walking as soon as possible after the surgery to promote a faster recovery and prevent blood clots. You should avoid lifting or pushing heavy objects or vigorous exercises for a few weeks.
As with any surgery, laparoscopic surgery for ulcerative colitis involves certain risks and complications such as infection, bleeding and splitting of the resected intestine.