What is a laparoscopic ileocolectomy?
A laparoscopic ileocolectomy is an operation that removes a diseased section of the ileum (last segment of the small intestine) and ascending colon (first segment of large intestine).
(Figure to right:
Laparoscopic ileocolectomy removes a diseased section of the ileum (not shown) and ascending colon (lighter shaded area).
A laparoscopic ileocolectomy is an operation that removes a diseased section of the ileum (last segment of the small intestine) and ascending colon (first segment of large intestine).
The surgery is used to treat:
-
Cancer
-
Non-cancerous growths
-
Areas of swelling (inflammation) due to Crohn's disease
The term "laparoscopic" refers to a type of surgery called laparoscopy. Laparoscopy enables the surgeon to complete the surgery through very small "keyhole" incisions in the abdomen. A laparoscope, a small, telescope-like instrument, is placed through a small incision near the bellybutton.
What happens during the surgery?
There are four main steps to this surgery.
Step 1: Positioning the laparoscope
Once you are under anesthesia, the surgeon will make a small cut (about
1
/
2
inch) near the bellybutton. A laparoscope will be inserted into the abdomen through this incision. Images taken by the laparoscope will be projected onto video monitors placed near the operating table.
Once you are under anesthesia, the surgeon will make a small cut (about / inch) near the bellybutton. A laparoscope will be inserted into the abdomen through this incision. Images taken by the laparoscope will be projected onto video monitors placed near the operating table.
Once the laparoscope is in place, the surgeon will make two to four more "keyhole" incisions in the abdomen.
( Figure to the right:
Laparoscopic surgery is performed through 5 or 6 small incisions in the abdomen. Surgical instruments will be placed through these incisions to complete the surgery.)
Step 2: Dividing the ileum and ascending colon
The diseased section of ileum and ascending colon must be cut away from the healthy bowel. Before this section can be removed, it must be freed from its supporting structures.
The bowel is attached to the abdominal wall by a layer of tissue called the "mesentery." The mesentery also contains the main blood vessels (arteries) that supply blood to the ileum and ascending colon. These arteries will be carefully cut and closed. Your surgeon will then free the part of the ileum and all of the ascending colon from the mesentery. After the bowel is free from the mesentery, the surgeon will cut away the diseased section of bowel.
Step 3: Removing the diseased bowel
The incisions in laparoscopy are very small, so the diseased section of bowel must be removed in a special way. Your surgeon will enlarge one of the incisions and place a bag into the abdominal cavity. The diseased bowel is placed into this bag. The bag is then pulled out of the enlarged incision.
Step 4: Rejoining the ends of the colon
After the bag has been removed, the ends of the colon will be pulled through the enlarged incision. Your surgeon will then use a stapling device or sutures (stitches) to rejoin the bowel. This end-to-end rejoining is called an "anastomosis."
The operation is completed by rinsing out the abdominal cavity and checking the anastomosis for leaks. Lastly, all of the keyhole incisions in the abdomen will be stitched or taped closed.
Recovering at home
You will be encouraged to increase your activity level steadily once you are home. Walking is great exercise! Walking will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots, and helping your lungs remain clear. If you are fit and did regular exercise before surgery, you may resume exercising when you feel comfortable.
There are only two things you are not permitted to do for six weeks after surgery: lift or push anything over 30 pounds or do abdominal exercises such as sit-ups.
You will be encouraged to increase your activity level steadily once you are home. Walking is great exercise! Walking will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots, and helping your lungs remain clear. If you are fit and did regular exercise before surgery, you may resume exercising when you feel comfortable lift or push anything over 30 pounds or do abdominal exercises such as sit-ups.
You will be sent home on a soft diet, which means you can eat most everything except raw fruits and vegetables. You should eat this diet until your post-surgical check-up. If the diet is making you constipated, please call your doctor for advice.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/15/2006
