Bowel Resections

Surgery to remove the bowel can be required for a number of reasons:

• Colorectal cancer: colorectal cancer is the third most common type of newly diagnosed cancer in Australia. Some patients will present with change in the bowels, bleeding, abdominal pain or weight loss. Other patients with no symptoms have cancer diagnosed after participating in the national bowel cancer screening program (stool test). Diagnosis is made with colonoscopy and CT scans.
• Diverticular Disease: Involves the formation of small out-pouches (diverticula) in the colon wall that can become inflamed or infected, causing symptoms like abdominal pain, fever, and changes in bowel habits. Diagnosis is often through imaging studies like CT scans, and treatment can involve antibiotics, dietary changes, and in severe cases, surgery.
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis): These are conditions where there is inflammation in the small and/or large bowel. Patients require surgery if medications are not controlling symptoms, or if there is narrowing in the bowel or fistulas to other organs.
• Endometriosis: Endometriosis can involve the large bowel and sometimes removal of a segment of bowel is required to improve symptoms.

Our surgeons are skilled in all approaches to major colorectal surgery:

• Robotic surgery
• Laparoscopic (keyhole)
• Open surgery
• Transanal surgery (TAMIS)

Our preference is to perform minimally invasive approaches to major colorectal surgery where appropriate as there are advantages with quicker recovery and reduced wound issues.

Types of major colorectal surgery:

• Right Hemicolectomy – removal of the ascending colon. The small bowel is joined to the transverse colon.
• Left Hemicolectomy – removal of the splenic flexure and descending colon. The transverse colon is joined to the descending/sigmoid colon.
• Subtotal colectomy – removal of the Ascending, transverse and descending colon, the small bowel is joined to the sigmoid colon.
• High anterior resection – removal of the sigmoid colon and the upper rectum.
• Low anterior resection – removal of the sigmoid colon and middle portion of the rectum.
• Ultralow anterior resection – removal of the entire rectum, typically for tumours close to the anal verge. 
• Total colectomy and ileorectal anastomosis – removal of the Ascending, transverse and descending and sigmoid colon. The small bowel (ileum) is joined to the rectum (distal part of the large bowel)
• Proctocolectomy and ileal pouch anal anastomosis (IPAA) – removal of all the large bowel including the rectum and construction of a small bowel ‘J’ pouch