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Robert Sewell, MD, FACS

Minimally Invasive Surgeon - Southlake, Texas

What is the Colon?


The colon is also called the large intestine and is the last portion of the intestinal tract. Its approximately 5 to 6 feet long. Beginning in the lower right part of the abdomen, the colon winds around the entire abdomen, ending at the rectum. The small intestine and the appendix are both attached to the first part of the colon, called the cecum. The other segments of the colon are named according to their relative location or shape. They include the right or ascending colon, the hepatic flexure, the transverse colon, the splenic flexure, the left or descending colon, and the sigmoid colon. The colon’s function is to absorb water from waste material coming from the small intestines and then expel that waste from the body.

Colon Cancer


Colon cancer is one of the leading causes of cancer related deaths in the United States. It typically begins as a growth within the tissues lining the inside of the colon, and over time tends to spread outside the colon to other parts of the body. The most effective treatment for colon cancer is surgical removal of that segment of colon where the cancer is found. This involves removing not only the growth, but also some of the surrounding normal colon and the blood vessels going to that segment of the colon. Lymph nodes near the tumor are carefully examined under the microscope to determine whether or not the tumor has spread. Additional treatments, such as chemotherapy or radiation therapy, may be recommended after surgery, depending on the stage of the cancer.


Minimally Invasive Treatment Options


To remove a section of the colon is considered a major operation. These procedures have traditionally been performed through a large abdominal incision. However, in many situations, laparoscopic surgical techniques can be used to perform the operation without the need for a large incision. The diseased portion of the colon is removed and the remaining ends are reconnected either by sewing them together, or with specialized stapling instruments, all through very small incisions.  Typically patients are hospitalized for only 3 or 4 days following uncomplicated laparoscopic colon resections, and are able to return to work within a week or two. 


The Single Incision Laparoscopic Option


A new type of minimally invasive surgical technique has recently been introduced that further reduces the number of incisions needed in colon resections. Referred to as Single Incision Laparoscopic Surgery, it is often possible to remove a portion of the colon using only one small incision, usually only about two inches long. The benefit of this technique is largely the smaller scar, but there may be other advantages in some cases. 


Benign Colon Problems


A variety of non-cancerous colon problems can occur that may require surgery, including:


  • obstruction or blockage

  • inflammation (colitis)

  • bleeding

  • perforation

  • tumors


The more common specific diagnoses include:


  • diverticulitis

  • ischemic colitis

  • adenomatous polyps

  • tubovillous adenomas

  • familial polyposis

  • sigmoid and cecal volvulus


Removal of some or all of the colon may be necessary to manage some benign conditions.