You or someone you know and love must have felt a little scared and a heavy burden on your heart when the doctor told you about this kind of surgery, right? It's normal to be nervous when you hear a big name like "Laparoscopic Abdominoperineal Resection." But don't be afraid. Today, we'll talk about what kind of surgery this is, why it's done, and what happens after the surgery in a very simple way that you can understand.
Simply put, what is this surgery?
This is a surgery performed by a surgeon. Your anus, rectum, and the lower part of your large intestine (sigmoid colon) are removed. This surgery is done through several small holes in your abdomen, rather than through a large incision. This method is called laparoscopy or "keyhole surgery."
This surgery is usually recommended if the cancer is located deep in the rectum or near the anus. This surgery is especially necessary if the cancer is located very close to the sphincter muscles that control the passage of stool, as this surgery is necessary to completely remove the cancer cells along with those muscles.
The most important thing is to completely remove the cancer from the body. This surgery does that.
In this surgery, a new opening is created for waste (feces) to exit your body. This is called a stoma . This stoma is located on the skin of your abdomen. It is through this that the large intestine is connected. Doctors also call this procedure a "colostomy."
What is a stoma? Should I be afraid of it?
Not at all. A stoma is an important part of your life-saving surgery. Think of it this way, just like our anus, this is a new way for waste to exit.
But there is one difference. The stoma does not have the sphincter muscles that control the passage of stool, like the ones in our anus. Therefore, we cannot control the passage of stool when we want. For this reason, we need to wear a special bag (pouch) to collect the waste that comes out.
It may feel a little strange to get used to this at first. But over time, it will become a normal part of your life. To help you with that, there are nursing staff who have received special training in this. They will teach you everything.
How the surgery is performed step by step
It's normal to feel nervous when thinking about such a major surgery. But once you understand how it's done, your fear will be greatly reduced.
| Stage of Surgery | What Happens |
|---|---|
| 1. Anesthesia | First, you will be fully anesthetized. This means that you will not feel anything until the surgery is over, and you will be completely asleep. |
| 2. Starting laparoscopy | While you are asleep, the surgeon makes a small incision (about 1/2 inch) near your belly button and inserts a small camera-like instrument (laparoscope) through it. This camera allows you to see inside your abdomen. Then, about 4 or 5 small holes are made in your abdomen to insert the instruments needed to perform the surgery. |
| 3. Preparing for bowel removal | The main blood vessels that supply blood to the part of the colon that is to be removed are cut and closed. Then, the part of the colon that is to be removed (sigmoid colon) is freed from the surrounding tissue and separated from the remaining large intestine. The rectum is also freed from the surrounding tissue in the same way. |
| 4. Removal of the anus | After the bowel segments are freed, another member of the surgical team will perform surgery in the area between your legs (perineal region) and completely remove the anus, rectum, and the affected part of the colon. |
| 5. Stoma Creation | After removing the cancerous tissue, the surgeon creates a stoma through a small hole that was previously made. This is usually made on the left side of the abdomen. The remaining end of the colon is brought out through the hole, connected to the skin, and sewn shut. |
| 6. Completion of the surgery | Finally, the abdominal cavity (inside the stomach) is thoroughly washed, and a small drainage tube is placed to drain any unwanted fluids that may have accumulated inside. This helps the wound heal faster. Then, the other incisions in the stomach are sewn up. |
What to expect during recovery?
After the surgery, you will need to stay in the hospital for a few days, usually about a week. During this time, the doctors and nursing staff will take good care of you.
What happens at the hospital?
When you wake up after surgery, a pouch will be attached to your stoma to collect waste. It will take a few days for your digestive system, or intestines, to start working again. Once it does, you will be given liquids to drink at first . As you gradually heal, you can move on to regular solid foods .
Learning to care for your stoma
This is the most important part. While you are in the hospital, a nurse who has been specially trained in stoma care (Enterostomal Therapist or ET nurse) will help you.
- They will show you how to change your stoma bag.
- It teaches you how to keep the skin around the stoma clean and healthy.
- When you go home, you will practice how to do these things on your own.
Living with a permanent colostomy is a big change. Give yourself some time to get used to it. Don't worry about anything. Your ET nurse is the best person to ask any questions you may have and get help from.
If you have any concerns or questions at any time, don't be afraid to talk to your doctor or ET nurse . They are there to help you.
Take-Home Message
- This surgery (Laparoscopic Abdominoperineal Resection) is a major surgery that can be life-saving for rectal cancer.
- Because this is done using the "keyhole" method (Laparoscopy), there are no large incisions, so the recovery time is relatively quick.
- After surgery, you will need to use a permanent opening in your abdomen (stoma) to allow waste to exit and a bag (pouch) to collect waste.
- Although learning to manage a stoma can be challenging at first, it can be easily done with the help of specially trained nursing staff.
- This is a big change, both physically and mentally. So be open and honest with the doctors, nurses, and family who are there to support you. You are not alone.
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