COLON SURGERY
EXPERIENCE IN LAPAROSCOPY
Dr. Mandelbaum completed his training before laparoscopic colon surgery was taught to surgical trainees in Canada. At that time laparoscopy for colon surgery was just making its way into community hospitals. This area of surgery was his calling as he quickly saw the benefits that these techniques would bring to Scarborough. With training and further education, he has gained a perspective that spans two different eras of surgery in Canada and the experience and judgement to help you make the right choices in your care.
In laparoscopic colon resections several small incisions each under 1cm are made to insert a camera and long instruments. The work is all done inside and any piece of intestine removed is taken out through a very small incision usually made in the lower abdomen.
Dr. Mandelbaum helped to bring laparoscopy for colon surgery to the Scarborough Hospital. He performed the first laparoscopic colon resection at the Scarborough General Hospital in 2005 and has become only more experienced and proficient in the years since.
Most colon surgery at the Scarborough Hospital is now done laparoscopically resulting in decreased hospital stays, less pain and fewer incisional hernias for patients.
Dr. Mandelbaum is comfortable performing both resections for cancer, inflammatory bowel disease and diverticulitis as well as reconstructions for patients with ostomies.
TEAM APPROACH
Dr. Mandelbaum works closely with his partners at the Scarborough Hospital, particularly Dr. ABU-OMAR and Dr. Orzech. This team collaborates frequently in consultation, surgical planning as well as in the operating room to tackle difficult cases.
COLON RESECTIONS
Colon resections (removing a piece of colon) are most frequently done for cancer, inflammatory bowel disease and diverticulitis.
COLON RECONSTRUCTIONS
Colon reconstructions are done for those who have had some type of surgery, often involving a stoma (a bag on the skin into which the feces empties) in order to restore the normal rectal route of defecation.
COLON CANCER
Colon cancer is very common in Canada and a disease with which Dr. Mandelbaum has an enormous amount of experience. All colon cancer cases at the Scarborough Health Network are reviewed by our tumour board. A tumour board is a group of health care professionals, including surgeons, medical oncologists and radiation oncologists, that meet regularly to ensure all cancer cases receive the best care in a coordinated manner.
STOMAS: ILEOSTOMY AND COLOSTOMY
A stoma simply means an opening. An ileostomy is a piece of small intestine that has been surgically placed through the abdominal wall. The intestinal contents empty into a bag that is affixed to the skin.
A colostomy is a piece of large intestine that has been surgically placed through the abdominal wall. The intestinal contents empty into a bag that is affixed to the skin.
The American College of Surgeons has a comprehensive set of documents and videos to support people with ostomies. Click on the picture to the right to view the many links there to explore background information, how to change the bags, preventing leaks, and many more topics.
There are also an enormous number of excellent videos on youtube that can help you get by with your stoma. Simply search in the youtube search bar for the topic you want, for example “ileostomy bag change”, or “colostomy leakage problem” and you will find a lot of assistance.
If you are having difficulties please do not hesitate to call us or come in to be seen.
ERAS: ENHANCED RECOVERY AFTER SURGERY
ERAS is a set of evidence-based principles that support better outcomes for surgical patients including: an improved patient experience, reduced length of stay, decreased complication rates and fewer hospital readmissions. ERAS guidelines focus on the following areas:
- Patient and family engagement
- Nutrition management
- Perioperative fluid and hydration management
- Multi-modal opioid sparing analgesia
- Perioperative best practices
- Mobilization
WHAT DOES ERAS MEAN FOR ME AS A PATIENT?
It means that to achieve the best outcome for you we need you, as a patient, to be informed and involved. Getting better after surgery involves significant effort on the part of both the care team and our patients, particularly in the face of pain and discomfort.
The main points of effort on the part of the patient and their family include:
- Following instructions for your medication
- Eating and drinking properly prior to surgery (don’t come dried out!)
- Getting moving immediately after your operation
You need to read and understand the Scarborough Health Network ERAS guide book
THE SURGICAL JORNEY
Scarborough Health Network (SHN) is committed to partnering with you and your family for a quality patient experience. Your health care team will work with you to meet your needs and reach your care goals.
This guide provides you and your family with helpful information about your surgical journey. It will answer many of your questions and help you be actively involved in your care.