Laparoscopic Abdominoperineal Resection
Step 3: Preparing the Anus for Removal
Once the sigmoid colon and rectum have been prepared for removal, one of the surgeons will operate on the area between the legs (perineal region). This operation will allow the surgeon to remove the anus, rectum, and sigmoid colon.
Step 4: Making the Stoma
Once the anus, rectum, and sigmoid colon have been removed, the surgeon will make the stoma from one of the existing incision sites. The stoma is usually placed on the left side of the abdomen.
First, a small disk of skin will be removed from the incision site. The open end of the descending colon will be pulled through this site to the surface of the skin. (This type of stoma is called an "end colostomy") The stoma will be stitched in place. The abdominal cavity will be rinsed out and a small drainage tube will be inserted into one of the lower abdominal incision sites. This drainage tube will promote healing of the tissue inside your abdomen. Finally, your surgeon will carefully inspect the abdominal cavity and stitch the incisions closed.
Recovery From an Abdominoperineal Resection
Hospital stays after abdominoperineal resection average 1 week. You will be fitted with a pouch immediately after surgery. It will take a few days for your digestive system to become active again. When it does start functioning, you can begin to drink liquids. As you improve, you can begin eating solid foods again.
While you are recovering, your enterostomal therapist (ET), a nurse specially trained in the care of the stoma, will change your pouch for you. You will learn a lot about changing the pouch by watching and talking with the ET nurse. You will also be given instructions and coached through the process so you will be independent when you get home.
You are bound to go through many psychological and physical adjustments after surgery. It will take time to cope with all of these changes and, at times, you may feel overwhelmed. Your ET nurse is a great resource. Do not hesitate to call him or her after surgery for further support.