Colon and Rectal Surgery at Swedish Hospital
Swedish Hospital utilizes the latest minimally invasive and robotic techniques for colon and rectal surgery, when possible. This, in combination with our use of the most recent Early Recovery After Surgery (ERAS) protocols, minimizes recovery time and maximizes patient success.
For more information and to schedule an appointment with a surgeon, please call
773-293-8878.
General Questions About Colon and Rectal Surgery
What are Colon Surgery and Rectal Surgery and How Are They Different?
Colon surgery refers to operating on the portion of the large bowel before the level of the pelvis. Past this point, the large bowel becomes the rectum.
There are anatomic differences past the point of the pelvis and as it moves toward the anus. This includes different lymphatic and venous drainage patterns, as well as anatomic variances.
These differences require different treatment protocols and surgical approaches.
When Should I See a Colorectal Surgeon?
You should see a colorectal surgeon when referred by a gastroenterologist or primary care physician. Some common reasons for this include:
- Colon/rectal cancer
- Uncontrolled bleeding from the bowels
- Inflammatory bowel disease, including Crohn’s
- Diverticulitis
- Preventative surgery for certain genetic conditions
- Hemorrhoids
- Fissures or fistulas
What Procedures Do Colorectal Surgeons Perform?
The most common procedures performed by colorectal surgeons include:
- Bowel resections (including colectomies)
- Treatments of hemorrhoids
- Benign anorectal procedures to treat fistulas, fissures or peri-rectal abscesses
- Reversal of ileostomies or colostomies
What is a Colectomy?
A colectomy is a resection of a portion of your bowel. In most cases at Swedish Hospital, the bowel is put back together.
At times, it is not safe to re-connect or anastomose the bowel. In these cases, we may divert the gastrointestinal (GI) tract. Our goal is for this to only be a temporary diversion, and when appropriate it can often be reconnected at a later date.
Please talk to your surgeon about this if you have questions.
Is Colorectal Surgery Done Minimally Invasively? What About Robotically?
The type of colorectal surgery determines whether a procedure can be done minimally invasively or robotically. There is great benefit to these approaches when appropriate, but the safety of the patient always comes first.
Some common examples include:
- Benign anorectal procedures are typically smaller procedures and are considered open
- Colon and rectal resections done for cancer or benign disease at Swedish Hospital are typically done utilizing minimally invasive techniques, including robotic surgery. Speak with your surgeon to see if this approach is appropriate for you.
- At Swedish Hospital, colon resections utilize the most current techniques, where appropriate, including:
- Minimally invasive/robotic colon resections
- Intra-corporal anastomoses (proven to reduce time to return of bowel function)
- Segmental resections with sewn anastomoses
- Utilization of Indocyanine Green for live bowel perfusion to ensure good blood supply to areas =====where bowel is re-connected
How Serious is Colorectal Surgery?
The seriousness of colorectal surgery depends on the type of procedure. Colorectal resections are considered major surgery, while some benign anorectal cases can be considered minor.
There is a spectrum for each procedure, and discussing your options with your surgeon is always recommended.
What to Expect From the Procedure and Recovery
Is Colorectal Surgery Painful?
Anytime there is an incision, you must expect some amount of pain; however, significant advancements have proven to minimize pain and the use of narcotics.
At Swedish Hospital we utilize:
- Minimally invasive techniques
- Intracorporeal anastomosis (connecting the bowel back together inside of the body)
- Pain blocks which deaden the pain fibers in the area of the surgery for two to four days after surgery
- Utilization of non-narcotic pain medications.
How is a Mass Removed From Your Colon?
A mass in your colon typically removed through multiple small incisions. Along with the mass, the surgeon also removes that portion of the bowel and the associated structures.
How Long Does it Take to Recover From Rectal Surgery?
The length of recovery depends on the type of procedure you will undergo. In most cases, it will require a multi-stage approach. Full recovery typically takes at least six weeks.
While in-hospital recovery for colorectal resections for open procedures averages nine days nationally, scheduled minimally invasive colorectal surgeries at Swedish Hospital average less than four days. This is due in part to our strict adherence to the most recent Early Recovery After Surgery (ERAS) protocols, which minimizes recovery time.
After a patient is discharged, the next stage in the road to recovery begins at home. Patients can expect this to take two to four weeks, depending on the surgery.
What Can I Expect Before, During and After Colon Surgery?
We recommend patients begin their recovery prior to surgery. It is important to follow a good nutrition and hydration plan in the weeks leading up to colorectal surgery. Patients are screened at our clinics for those eligible to receive free nutritional supplementation which is shown to decrease post-operative complications.
Prior to the day of surgery, many of these procedures require a bowel prep similar to that prior to a colonoscopy. These are very important, and they are required for putting the bowel back together.
The day of surgery and the postoperative period are unique to each procedure and the techniques being used. Some common situations include:
- Colorectal resection patients can expect to stay in the hospital for two to ten days
- After surgery on the GI tract, it is typical for your bowel to take one to seven days to ‘wake up’ and have return of bowel function. During this time your belly can become distended until things are again passing through.
- During this time we encourage ambulation. Ambulation is the only proven post-operatively to decrease the time to return of bowel function.
- Your diet will be advanced as tolerated. Most patients are eating solid food one to two days after surgery.
- You should expect the first few bowel movements after colorectal surgery to be loose as your bowel function returns.
There may also be a small amount of blood in the first one or two bowel movements.
Once a patient is meeting post-operative goals, they are discharged from the hospital. Some of these post operative goals are return of bowel function, ambulation, good pain control and stable labs and vitals.
The postoperative period once home is focused on time to heal the work that was done. We typically have a postoperative visit in the clinic one to two weeks later, depending on the surgery.
What Foods Should You Avoid After Colon Surgery?
After a colectomy, we advise patients to avoid foods which carry a higher risk of food poisoning such as undercooked or raw meat and fish. We also recommend limiting foods such as raw stringy vegetables that are difficult for your body to digest.
The most important thing after colectomy is to ensure sufficient hydration by drinking water or electrolyte drinks and avoid things that cause dehydration such as caffeinated drinks or alcohol.
We provide patients with a list of appropriate foods in the initial period and subsequently after colectomy and are happy to discuss this during consultation.
Contact Us
For more information and to schedule an appointment with a surgeon, please call
773-293-8878.
