Our Summary

This research paper is trying to compare the effectiveness of different techniques used in a type of surgery called laparoscopic sigmoid colectomies (a minimally invasive procedure to remove part of the colon). The three techniques are:

  1. Straight laparoscopic: Where the entire procedure is done using a laparoscope (a small tube with a light and camera).

  2. Hand assisted: A surgeon’s hand is used along with the laparoscope.

  3. Laparoscopic assisted: Only part of the procedure uses the laparoscope.

The researchers looked back at 191 patients who had this surgery between 2010 and 2014. They noticed that the choice of technique varied a lot between surgeons. They also noticed that hand-assisted procedures were more often used in obese patients.

After taking into account various factors that could influence the length of hospital stay, they found that on average patients who had the straight laparoscopic procedure left the hospital about 14-15% quicker than those who had the other two procedures.

They also found that patients who had the straight laparoscopic procedure regained normal bowel function (i.e., were able to poop) earlier than those who had the other two procedures.

In conclusion, the researchers suggest that when possible, the straight laparoscopic approach is the better technique as it allows patients to leave the hospital sooner and regain normal bowel function more quickly.

FAQs

  1. What are the three techniques compared in this research for laparoscopic sigmoid colectomies?
  2. Did the choice of technique for laparoscopic sigmoid colectomies vary between surgeons?
  3. According to the research, which technique allows patients to leave the hospital sooner and regain normal bowel function more quickly?

Doctor’s Tip

A doctor might tell a patient undergoing a colectomy that choosing the straight laparoscopic technique may lead to a quicker recovery and shorter hospital stay compared to other techniques. This can help the patient get back to their normal activities sooner and improve overall outcomes.

Suitable For

Patients who are typically recommended for colectomy include those with conditions such as colon cancer, ulcerative colitis, Crohn’s disease, diverticulitis, and familial adenomatous polyposis. These conditions may require surgical removal of all or part of the colon to alleviate symptoms, prevent complications, or reduce the risk of developing cancer. Additionally, patients with severe colon inflammation, obstruction, or perforation may also require colectomy as a life-saving procedure.

Timeline

Before colectomy:

  • Patient undergoes pre-operative evaluations and tests to assess their overall health and determine if they are a candidate for surgery.
  • Patient may need to follow a special diet or take medications to prepare for the surgery.
  • Patient meets with their surgeon to discuss the procedure, potential risks, and expected outcomes.

After colectomy:

  • Patient is monitored closely in the hospital for any complications or signs of infection.
  • Patient may experience pain, discomfort, and fatigue following the surgery.
  • Patient gradually resumes eating and drinking, starting with clear liquids and progressing to solid foods.
  • Patient may need to stay in the hospital for several days to a week, depending on the extent of the surgery and their individual recovery.
  • Patient may need to follow a specific diet and lifestyle changes to support their recovery and prevent complications.
  • Patient may need to attend follow-up appointments with their surgeon to monitor their progress and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colectomy include:

  1. What are the different techniques available for colectomy, and which one do you recommend for me?
  2. What are the potential risks and benefits of each technique?
  3. How does the recovery process differ between the straight laparoscopic, hand assisted, and laparoscopic assisted techniques?
  4. Will my weight or any other factors impact the choice of technique for my surgery?
  5. How experienced are you in performing each of these techniques?
  6. How long can I expect to stay in the hospital after the surgery with each technique?
  7. How soon can I expect to regain normal bowel function after the surgery with each technique?
  8. Are there any long-term implications or differences in outcomes between the techniques?
  9. Are there any alternative treatments or approaches to consider?
  10. Can you provide any additional information or resources for me to learn more about colectomy and the different techniques available?

Reference

Authors: Midura EF, Hanseman DJ, Davis BR, Johnson BL, Kuethe JW, Rafferty JF, Paquette IM. Journal: Surg Endosc. 2016 Aug;30(8):3567-72. doi: 10.1007/s00464-015-4654-3. Epub 2015 Nov 5. PMID: 26541737