Colorectal Surgery with Transanal Excision procedure is an option for patients needing colon or rectal removal. In this procedure, the surgeon removes the colon or rectum and the surrounding tissue using minimally invasive, robotic or laparoscopic techniques. The bowel ends are hooked back up together. The procedure allows for the functioning of the anal sphincter and eliminates the need for a colostomy bag after surgery.
The major difference between this technique and other minimally invasive colon and rectal surgery is that the bowel is removed from the anus rather than an incision on the abdomen. Additionally, the bowel ends are sutured back together in a hand-sewn fashion rather than using staplers that need larger incisions on the abdomen. Only tiny incisions for robotic tools are made on the abdomen. Thus, there are no large incisions on the abdomen for removal of the specimen or for staplers.
Recovery
Recovery from the procedure usually involves a one-night stay in the hospital. Recovery from the procedure is typically quicker and more pain-free than other surgical approaches. Most pain felt after any surgery will be from the abdominal incision, which with this technique are minimal. Patients are usually able to walk right after and most do not need to use narcotic pain medication.
Frequently Asked Questions
Most patients are sent home with a weight lifting restriction of 15 lbs. for at least 6-weeks. Besides that, there are typically no restrictions on returning to work. However, it is not uncommon for patients to see how they fare at home for a few days before returning to work.
While the surgery is exactly the same as with other approaches such as open surgery with a large incision or laparoscopic/robotic surgery with removal of the specimen from abdominal incisions, the difference lies in the surgical technique which allows us to avoid larger incisions on the abdomen.
An added benefit of this procedure is minimal scarring due to avoidance of a larger incision on the abdomen. The patient typically will have small (8mm) incisions on the abdomen, which usually heals extremely well without complication.
Minimally Invasive Colectomy with Standard Specimen Removal from the Abdomen. This shows the bowel being brought out through the larger incision and the ends are hooked back up together after the bowel is resected with final incisions noted on the right.
Robotic Colectomy with Transanal Extraction. The bowel is divided and removed from the anus after which the bowel ends are sutured together inside the abdomen with robotic hand-sewn technique with the final incisions noted on the right.