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Colorectal Conditions

Inflammatory Bowel Disease (IBD) Treatment and Surgical Options

Ulcerative colitis and Crohn's disease are often chronic (long-term) illnesses. As a result, your doctor may recommend a long-term treatment using medication. There are two main goals of medication for inflammatory bowel disease (IBD): to bring the disease under control (into remission), and keep the disease in remission.

Fortunately, there are medications to treat mild to moderate IBD. You should discuss the medications, as well as all other treatments with your doctor. If medication or lifestyle changes do not ease your symptoms, your doctor may recommend surgery for IBD or its complications.

Surgery

Your doctor may recommend colon surgery (called a colectomy or colon resection), if medication does not ease your symptoms or if there are complications, such as an intestinal blockage. During surgery, doctors remove the affected part of the colon and then join together the remaining healthy portions of the colon (the reconnection is called an anastomosis).

A colectomy can be performed using traditional open surgery through a large incision or using minimally invasive laparoscopic surgery – through a few small incisions.

Open Surgery

With open surgery, also called laparotomy, your surgeon must make a large abdominal cut/incision to reach your colon and other organs. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. While open surgery allows your surgeon to see and touch your organs, it is invasive and can be traumatic on your body due to the large incision.

Traditional Laparoscopic Surgery

Laparoscopic surgery is minimally invasive – meaning surgeons operate through a few small incisions instead of a large open incision. During traditional laparoscopy, long-handled instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and those images are sent to a video monitor to guide surgeons as they operate on your colon.

da Vinci® Surgery

Another minimally invasive surgical option is da Vinci Surgery. With the da Vinci System, surgeons make just a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.

da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.


All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.

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