Laparoscopic Surgery at Naperville Surgical Associates
Naperville Surgical Associates have been leaders in Laparoscopy since 1990. Dr Sal Piazza performed the first laparoscopic gallbladder at Edward Hospital in 1990. Dr. David Piazza performed the first laparoscopic colon resection at Edward Hospital in 1993. Our surgeons perform hundreds of laparoscopic procedures each year for Hernias, Appendix, Gallbladder, Diverticulosis, Colon polyps, Colon cancer, GERD (gastric reflux), Splenectomy, and Adhesions.
Laparoscopic Colon Surgery
Laparoscopic surgery of the colon is generally performed on patients who have diverticulosis, colon cancer, and colon polyps. Let's talk about patient selection, each illness and more detail about the procedures and recovery.
Diverticulosis and Diverticulitis
Diverticulosis is a problem with the colon where little pockets pop out through the muscle layers that cover the colon. The cause is not enough fiber in the American diet. Generally it takes years to develop this problem and it is thought that not enough fiber for periods up to 10 years may be necessary. Fifty percent of patients over fifty years old in the United States will have diverticulosis pockets.
The pockets are caused when the inner mucosa lining of the colon gets pushed through the muscle layer of the colon in places where the blood vessels penetrate the muscle to feed the mucosa. This creates a thin blister made only of mucosa to appear on the outside of the colon. The opening of the blister is on the inside of the colon and can fill with stool.
Diverticulitis is the name of the problem when one of these pockets gets infected or bursts. To be clear we must emphasize the fact that someone with diverticulosis has the pockets present. A patient who has an infection of one of those pockets has diverticulitis. You may have been told in the past that you have diverticulosis after either colonoscopy or X-rays have shown the pockets. Remember that you have never had diverticulitis if you have never had an infection.
People who have had infections with diverticulitis may need surgery. It depends on a number of factors. How bad was the infection? Was there an abscess or evidence of perforation? People less than 40 with one attack generally need surgery. People with two or more attacks requiring antibiotics and/or hospitalization also generally need surgery. The best people to help you determine whether surgery is necessary is your family doctor and your surgeon.
If you are unsure whether surgery is necessary we will be happy to provide a consultation. Please call our office for an appointment if you think you may need an operation. We do not operate on every patient we evaluate and we will be happy to treat you medically and offer you counseling and dietary information on how to avoid surgery in the future.
In general a diet high in fiber is recommended with 20 to 40 grams of fiber each day. The nuts and seeds theory of diverticulitis is generally not accurate, but if you have had an attack caused by popcorn or hard shell nuts and seeds you should avoid them in the future. Keep in mind that cucumbers and tomatoes are excellent sources of fiber and generally not implicated in diverticulitis. Strawberry seeds are practically seen only under a microscope, please eat strawberries. Come in for your consult to learn more and get all questions answered.
Colon and Rectal Cancer and Polyps
Colon cancer is currently the second most common cause of cancer death in the United States however if men and women are looked at separately the order is as follows:
Women: Lung, Breast, Colon
Men: Lung, Prostate, Colon
It is felt that up to 6% of Americans will get colon cancer by the time they are 80 years old. If you have a first degree relative with colon cancer (mother, father, sister, brother, or child) your chances can rise as high as 15 to 20% as a lifetime risk.
All patients should get a screening colonoscopy at age fifty. Everyone. No exceptions. This is the screening policy recommended by all groups including the American Cancer Society and Medicare. If you have a first degree relative with colon cancer colonoscopy should be performed starting at age 40 or at the age 5 years younger than the youngest patient in the family with colon cancer.
If you have had polyps or colon cancer yourself or a family member with colon cancer you will need colonoscopy every three to five years.
You should also have colonoscopy if you are an adult with blood in the stool, black or tarry stool, narrowing of the stool, changes in bowel habits such as diarrhea or constipation, unexplained abdominal pain, profound weight loss, mucous in the stool or if the stool turns a test positive for microscopic blood.
All of our surgeons do Colonoscopy and please call our office to schedule an appointment if you feel you require the procedure. Colonoscopy can prevent colon cancer because the cancer starts as a noncancerous polyp and stays in the pre-cancer phase for 3 to 5 years.
Any polyp that is too big to be removed safely by colonoscopy will require surgical removal. Polyps that have cancer in them or polyps that are too flat and cover a large area will also require surgical removal.
Any invasive colon cancer will require surgery to remove and treat the cancer. There are many techniques to remove colon and rectal cancer and the decision making as to which technique is the best is complicated and requires a case by case analysis by a qualified surgeon. All of our surgeons are board certified and can give you an expert opinion regarding each specific case.
Patient Selection for Laparoscopy
Not all patients will be best treated by Laparoscopy and it takes a surgeon with significant training and experience to guide you through the selection of the operation or technique that is best for each specific condition.
In general if you are less than 100 pounds overweight, if you have not had prior complex abdominal surgery and you are a good candidate for general anesthesia you may qualify for Laparoscopic Colon surgery.
Our surgeons all enjoy doing laparoscopic surgery and are proficient with the technique. We have done enough procedures to tell most patients up front whether they would be a good candidate. We handle many complex patients who have been turned down for laparoscopy by other surgeons. We actually have done more laparoscopic surgery than virtually all surgeons in the universities in the Chicago area. We are not a teaching facility for residents or fellows and each operation is done by two of our board certified surgeons working together.
The Laparoscopic Colon Operation
Patients will require a bowel prep that is generally done at home the day before surgery. It requires a prep to clean out the colon and oral antibiotics that sterilize the intestine.
The Laparoscopic Colon Operation
Patients come in on the day of surgery. The usual hospital stay being 3 to 5 days. Patients go home after they are able to tolerate a diet and some form of intestinal function is demonstrated.
Patients are up and walking the day of surgery, generally start liquids the day after surgery and are able to shower within 24 hours.
Patients will be visited by one of our Board Certified Surgeons each day you are in the hospital including weekends and holidays.
The Laparoscopic Colon Operation
Shorter hospital stay, early return to eating, early return to work, and faster return to recreational activities and exercise are the features of all laparoscopic abdominal procedures.
Patients return to work much more rapidly than with the 'open' technique. For desk jobs the return is usually 2 to 3 weeks. Jobs that require significant lifting, bending, pushing or pulling require 4 to 6 weeks.
Light exercise such as treadmill and stationary bike can be started in 7 - 10 days. Contact sports and strenuous exercise generally require 6 weeks. It requires consultation with the surgeon for more specific activities.
The real reason to have your procedure done via laparoscopy is less pain. All other reasons to have laparoscopy do not measure up to the fact that it is much less painful via the laparoscopic technique.
Summary of Laparoscopic Colon Surgery
at Naperville Surgical Associates
Our surgeons do more Laparoscopic Colon Surgery than any other surgical group in Du Page County and the surrounding communities. We use two board certified surgeons on each case. Our office provides outstanding service and follow up care. We provide dietary counseling and complex medical care for conditions requiring colon resection. We integrate with other specialists at Edward Hospital to provide comprehensive cancer care including chemotherapy and radiation treatment if necessary. We provide colonoscopy for screening and surveillance, but will also work with your gastroenterologist.
Naperville Surgical Associates is ready to provide you with the comprehensive care you need for your Laparoscopic Colon Surgery. Our team of surgeons and office staff are uniquely qualified to deliver your care in an expert and compassionate fashion.
As always, thank you for the privilege of providing you with your surgical care.
For more information about the surgeons at Naperville Surgical Associates and the medical and surgical services we provide, please fill out our contact form or call us at (630) 355-5633.