Not so long ago, surgeons needed to make a 10- or 15-inch incision in a person’s abdomen to remove a person’s colon.
Today, a person’s entire large intestine and rectum (which make up the colon) can be removed leaving only a coin-sized scar hidden in a person’s belly button.
In my practice, I remove one or two colons each week using this technique.
Warning: The video is graphic. Viewer discretion is advised.
One of the unique facets of colon surgery, which is not true for every specialty, is that the surgeon must remove the colon intact. This means that we always need to make a 2- to 3-cm incision to get the colon out. Three centimeters is plenty of room to put two instruments and a camera and remove a colon with no added incisions.
This procedure, which was first performed at Cleveland Clinic, is called a “single-port proctocolectomy.” It is a minimally invasive technique that offers many benefits to patients with colon cancer, Crohn’s disease, ulcerative colitis, diverticulitis or constipation when doctors advise that the colon be surgically removed.
Potential benefits of single-port proctocolectomy include:
- Minimal or no scarring
- Shorter hospital stays
- Faster recovery
- Reduced pain
Single-port proctocolectomy is theorized to improve female fertility after surgery by minimizing scar tissue in the abdomen.
You might wonder how did surgeons go from performing open surgery with 10- or 15 –inch incisions to using one small incision?
The procedure evolved over time as surgeons looked for ways to make smaller incisions, use fewer “ports” (or special incisions to insert instruments) and access different extraction sites to help camouflage scars.
As an improvement to open surgery, surgeons started with traditional laparoscopic surgery to remove the colon – another minimally invasive surgery that was first performed at Cleveland Clinic. This effective technique leaves four to six incisions in the person’s abdomen. A special rod connected to a video camera is inserted through a small incision in the person’s abdomen. Then, three to five additional small incisions are made and used as “ports” in which to insert instruments to remove the colon.
As this method proved successful, single-port proctocolectomy was performed as a new advancement. During the procedure, a special port is placed over the belly button, allowing for attachment to a camera and instruments for removing the colon all through one incision.
The goal is to make the hole exactly big enough to get the colon out. It’s an amazing procedure, just getting ride of the colon, getting rid of what is making [people] sick turns them around very quickly.
Today, Cleveland Clinic is one of the few medical centers in the nation offering single-port proctocolectomy. To watch me in the operating room performing this procedure and the minimal recovery time that resulted, watch the video with this post.