While minimally invasive surgery is shown to be as safe as open surgery, the recovery is expected to be faster and the risk of infection following surgery is smaller. Colectomy by minimally invasive surgery is associated with the quick return of bowel function (1-3 days) and a relatively short stay at the hospital (3-5 days after surgery). Patients who receive a colectomy performed with open technique should expect a longer stay at the hospital—1-4 days longer depending on the type of surgery. Similarly, bowel function may take 1 day longer to return after an open surgery.
Patients are encouraged to get out of bed and walk within one day, but they should limit stair climbing for about a week and avoid heavy lifting for six weeks. Most patients are able to eat solid food within a few days.
During recovery, all patients, regardless of surgery site, may encounter issues with:
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Constipation
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Increased frequency of bowel movements
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Abdominal pain
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Bleeding/pain at incision sites
After surgery: Open versus laparoscopic
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Oncological outcomes: |
Both laparoscopic and open surgery have similar outcomes in terms of overall survival, disease-free survival and port-site metastases. |
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Survival: |
There is no significant difference between laparoscopic and open colorectal surgery for colorectal cancer in terms of overall survival rates. |
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Length of Stay: |
Length of hospital stay is significantly shorter following laparoscopic colorectal surgery than with open colorectal surgery |
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Blood loss: |
Blood loss during surgery is significantly lower with laparoscopic versus open colorectal surgery |
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Blood transfusion: |
The proportion of patients requiring blood transfusion is lower with laparoscopic colorectal resection than with open colorectal resection |
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Incision size: |
Laparoscopic colorectal surgery requires a significantly shorter incision, leading to less scarring, than open colorectal surgery |
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Bowel function: |
Return of bowel function occurs significantly sooner in patients who have undergone laparoscopic colorectal surgery than in those who have undergone open colorectal surgery |
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Operating time: |
Studies show that the operating time associated with laparoscopic colorectal surgery is consistently and significantly longer than with open surgery |
Path to recovery: Surgery site
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Site of Surgery |
Recovery |
Risk |
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Slower return of bowel function |
Longer stay at the hospital |
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An increased risk of infections at the site of surgery |
Surgeons are more likely to create a temporary ostomy. May extend their stay at the hospital. |
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Risk of a leak and infection at the site of reattachment of the healthy ends of the rectum (anastomotic leak) and fecal incontinence. |
Surgeon may create a temporary ostomy to divert fecal matter away from the newly created anastomosis. |
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Low anterior resection (LAR) |
Increased risk of developing LARS syndrome (a collection of symptoms ranging from incontinence to constipation and incomplete emptying) following surgery. |
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Low anterior resection (LAR) |
Risk of nerve injury during low rectal dissection. |
Patients are more likely to experience sexual dysfunction. |
