My previous blog discusses the day I had surgery and how I felt the first few days after. In this blog I will try to explain what things were done to accomplish a total colectomy (removal of my entire large intestine). Instead of having a general surgeon perform my surgery, I had a specialist known as a colorectal surgeon perform mine. A colorectal surgeon specialized in this type of surgery.
The large intestine, or colon, is about 4-5 feet in length. It begins where the small intestine ends, at the ileocecal valve. Just after the large intestine starts is where the appendix is attached. (So I guess I've had my appendix removed.) The large intestine extends from the right lower quadrant of the abdomen up to about the rib cage, then across the belly and down. It then goes over to the middle of the belly, and finally down and out. The last few inches are actually anus, which is different tissue than the large intestines themselves.
To accomplish the surgery I had, they created some small lap-sites (laparoscopy sites). I think there were 3 of them. Through these sites a camera was inserted and instruments were inserted to perform the surgery. The doctors had to carefully disconnect the blood supply and connective tissue from the entire colon. I assume that was done first. Then they would have clamped and cut the large intestine at the beginning and end points. To remove it, they made a transverse incision right above my pubis bone. I refer to this as my c-section scar. It's not quite as wide as a c-section scar would usually be, but it is in the right spot. After the large intestine was removed then the next part of the surgery happened.
The next phase involved stapling the end of the small intestines (distal ileum) and then turning it into the shape of a J. At the bottom of the J an opening was cut. Then a stapling instrument would have been inserted to staple both sides of the J together. Two rows of staples would have been done simultaneously, with the instrument slicing down the center. Thus the J-Pouch was created. This connection is also referred to as ileoanal anastomosis. J-Pouch is a type of ileoanal reservoir. The remaining opening of this J-Pouch was then stapled to the anus. One part of this surgery remained.
Some surgeons consider the surgery basically finished as described above, but the surgeon I had isn't a risk taker. He wanted to give the J-Pouch time to heal, without stool passing through it, to reduce the chance of serious infection. Therefore a temporary diverting loop ileostomy was created. In the right part of my belly, a little below the level of the belly-button the small intestine was pulled up through one of the holes which had previously been made. This was not the end of the ileum, as that was now a J-Pouch at the end of the digestive tract. It was more like the intestine was bent in half and pulled through the hole. It was then cut partway through and sewn to my belly. This created the opening through which stool would pass into an ostomy bag for the next several months. This ileostomy had the appearance of a moist red/pink maraschino cherry with the skin off of it. All of my incisions would have been sewn closed and an ostomy bag was applied to the newly created ileostomy.
So what I woke up with after surgery was a c-section scar, a couple of small lap-sites and an ileostomy bag.
The large intestine, or colon, is about 4-5 feet in length. It begins where the small intestine ends, at the ileocecal valve. Just after the large intestine starts is where the appendix is attached. (So I guess I've had my appendix removed.) The large intestine extends from the right lower quadrant of the abdomen up to about the rib cage, then across the belly and down. It then goes over to the middle of the belly, and finally down and out. The last few inches are actually anus, which is different tissue than the large intestines themselves.
To accomplish the surgery I had, they created some small lap-sites (laparoscopy sites). I think there were 3 of them. Through these sites a camera was inserted and instruments were inserted to perform the surgery. The doctors had to carefully disconnect the blood supply and connective tissue from the entire colon. I assume that was done first. Then they would have clamped and cut the large intestine at the beginning and end points. To remove it, they made a transverse incision right above my pubis bone. I refer to this as my c-section scar. It's not quite as wide as a c-section scar would usually be, but it is in the right spot. After the large intestine was removed then the next part of the surgery happened.
The next phase involved stapling the end of the small intestines (distal ileum) and then turning it into the shape of a J. At the bottom of the J an opening was cut. Then a stapling instrument would have been inserted to staple both sides of the J together. Two rows of staples would have been done simultaneously, with the instrument slicing down the center. Thus the J-Pouch was created. This connection is also referred to as ileoanal anastomosis. J-Pouch is a type of ileoanal reservoir. The remaining opening of this J-Pouch was then stapled to the anus. One part of this surgery remained.
Some surgeons consider the surgery basically finished as described above, but the surgeon I had isn't a risk taker. He wanted to give the J-Pouch time to heal, without stool passing through it, to reduce the chance of serious infection. Therefore a temporary diverting loop ileostomy was created. In the right part of my belly, a little below the level of the belly-button the small intestine was pulled up through one of the holes which had previously been made. This was not the end of the ileum, as that was now a J-Pouch at the end of the digestive tract. It was more like the intestine was bent in half and pulled through the hole. It was then cut partway through and sewn to my belly. This created the opening through which stool would pass into an ostomy bag for the next several months. This ileostomy had the appearance of a moist red/pink maraschino cherry with the skin off of it. All of my incisions would have been sewn closed and an ostomy bag was applied to the newly created ileostomy.
So what I woke up with after surgery was a c-section scar, a couple of small lap-sites and an ileostomy bag.
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