Surgical Procedures & Innovations

Standard "Open" Surgical Incision for Left-Sided Colectomy

Port Wound Arrangement for Standard Laparoscopic Left Colectomy

Laparoscopic surgery is the standard of care, or operation of choice, for many procedures. The Columbia University Colorectal Care Program uses laparoscopic techniques for 90% of its colon surgeries. The benefits of laparoscopy, as opposed to "open surgery," include: less postoperative pain and therefore less pain medication, faster healing for a quicker return home, and smaller, less noticeable scars after healing.

During laparoscopic surgery, the abdomen is inflated with carbon dioxide gas to lift the abdominal wall away from the internal organs. Hollow cylinders called ports are inserted through 1/2" to 1" insertions in the abdominal wall to provide access for the surgical instruments. These ports have valves that permit insertion of instruments but prevent the carbon dioxide from escaping. The laparoscope, a fiber-optic telescope, is inserted through one port and attached to a camera. It sends images from the abdominal cavity to television monitors placed for easy viewing by all the operating room personnel. Thus, the surgeon and his or her assistants can view the abdominal cavity and its contents. Through the remaining ports, long-handled instruments are used to perform fine dissection, cutting, and suturing.