Clinical Associate Professor Rob Bohmer
(MBChB FRACS)
Gastrointestional & Laparoscopic Surgery
Rob Bohmer is a consultant general surgeon with a special interest in upper gastrointestinal, hepatopancreaticobiliary, oesophagogastric and laparoscopic surgery. He is a member of the Australian and New Zealand Oesophagogastric and Hepatopancreaticobiliary Surgical Societies (ANZGOSA & ANZHPBA) and is a licentiate of the Canadian Medical Council (LMCC). He completed his medical training in South Africa and his surgical training in New Zealand, followed by sub-specialist upper gastrointestinal and laparoscopic training in Adelaide (with professor Guy Maddern) and in Scotland (with Sir Alfred Cuschieri). He performed the first Tasmanian laparoscopic colon resection (2002), laparoscopic liver resection (2010), laparoscopic stomach and pancreas resections (2011) and laparoscopic oesophagectomy (2012). His main work comprises of gallbladder surgery, hernia surgery, surgery for cancer and anti-reflux surgery. Dr Bohmer commenced consultant practice in Hobart (2002) based at the Hobart Private and the Royal Hobart Hospitals. He is also a clinical associate professor through the University of Tasmania.
Surgery
- Laparoscopic (keyhole) Gallstone/Gallbladder Removal (Laparoscopic Cholecystectomy)
- Laparoscopic Hernia Repair
- Laparoscopic Surgery for Acid Reflux and Hiatus Hernia (Nissen Fundoplication)
- Achalasia surgery
- Surgery for Oesophageal, Stomach, Pancreatic and Liver Cancers
- Laparoscopic Surgery for Colon Cancer
- Endoscopy/Gastroscopy and Colonoscopy
Patient Information
Gallstones
The cause of gallstones is unclear, but genetics probably play a significant role in its occurrence. The symptoms of gallstones usually comprise of pain in the upper right abdomen (just below the rib margin), pain in the central upper abdomen, and sometimes, pain radiating to the back (in particular the right shoulder blade). This is associated with nausea, vomiting and belching. The pain usually lasts several hours and then disappears completely. The pain is often induced by the consumption of fatty foods. If an infection in the gallbladder develops, the pain may last for several days. If a gallstone passes down the bile duct, jaundice or pancreatitis may develop.
Treatment usually involves the removal of the gallbladder (laparoscopic cholecystectomy). This can be achieved through either a laparoscopic (keyhole) operation or an open operation. If the gallbladder is left alone, the gallstones usually re-form. Medication to dissolve gallstones is available but is not always effective. Breaking down the gallstones with a laser or ultrasonic device is dangerous, as this causes the stones to shrink in size, increasing the risk of the stones becoming stuck in the bile duct. Surgery is usually the best cure as long as the patient is fit for surgery.
Treatment usually involves the removal of the gallbladder (laparoscopic cholecystectomy). This can be achieved through either a laparoscopic (keyhole) operation or an open operation. If the gallbladder is left alone, the gallstones usually re-form. Medication to dissolve gallstones is available but is not always effective. Breaking down the gallstones with a laser or ultrasonic device is dangerous, as this causes the stones to shrink in size, increasing the risk of the stones becoming stuck in the bile duct. Surgery is usually the best cure as long as the patient is fit for surgery.
Complications, as with any operation, can occur. There is a chance that a keyhole (laparoscopic) procedure may have to be converted to an open operation (1-5% risk). Injury to the bile duct is the most significant complication but the least common (0.2% risk). An intra-operative cholangiogram (dye test on the bile duct during surgery) may help to reduce the risk of this complication occurring by detecting stones in the bile duct. The most common complication is an infection in one of the cuts (2%). Other complications include bleeding, bile leaks (1%) and blood clots. Occasionally, these complications require a return to the operating theatre for a second operation to correct the problem. Bruising around the cuts often occurs. Occasionally, scarring may be more visible than usual (hypertrophic scars). Overall, the risk of a significant complication associated with this procedure is less than 1%. Precautions against complications are always taken.
Recovery from laparoscopic gallbladder surgery is usually rapid. Most patients stay overnight but if the patient is fit for the surgery, it can be completed as a day case procedure. Most patients feel uncomfortable for 2-3 days following their operation and make a full recovery after ten days.
Recovery from laparoscopic gallbladder surgery is usually rapid. Most patients stay overnight but if the patient is fit for the surgery, it can be completed as a day case procedure. Most patients feel uncomfortable for 2-3 days following their operation and make a full recovery after ten days.
Hernias
Hernias mainly occur in the groin (inguinal hernia) and the umbilicus. They may occur following previous surgery (incisional hernia). A hernia is a hole in the abdominal muscle with intestine/bowel pushing through this hole. The cause of hernias is unclear, but it may be partly genetic. Smoking, coughing and heavy lifting may also be contributing factors. A hernia usually causes discomfort in the local area, especially when lifting heavy objects. A hernia may cause swelling and can occasionally become strangulated if the bowel/intestine is caught in the hole. It is usually best to treat a hernia.
Treatment requires surgery due to the small risk of strangulation. If you are unfit for surgery, a truss or support belt can be used. Surgery can be in the form of either an open operation or a keyhole (laparoscopic) operation. For recurrent hernias or hernias in both groins, a keyhole approach is usually preferable. For a groin hernia on one side, there is not a great deal of evidence suggesting that keyhole surgery is better, but it may offer a more rapid recovery. There is also some evidence that suggests a slightly lower risk of postoperative chronic pain after keyhole surgery. In both procedures, a mesh/gauze is used to cover the defect or hole in the muscle.
Treatment requires surgery due to the small risk of strangulation. If you are unfit for surgery, a truss or support belt can be used. Surgery can be in the form of either an open operation or a keyhole (laparoscopic) operation. For recurrent hernias or hernias in both groins, a keyhole approach is usually preferable. For a groin hernia on one side, there is not a great deal of evidence suggesting that keyhole surgery is better, but it may offer a more rapid recovery. There is also some evidence that suggests a slightly lower risk of postoperative chronic pain after keyhole surgery. In both procedures, a mesh/gauze is used to cover the defect or hole in the muscle.
Complications associated with hernia surgery include bruising, bleeding, infections, recurrence and chronic pain. Bruising is extremely common. The risk of recurrence is on average 2% for both open and keyhole operations. The risk is greater with an incisional hernia (a hernia related to previous surgery). Chronic pain is rare (in the order of 1-5%) and the exact cause of this is uncertain. Complications related to keyhole surgery include pain in the testicle (side operated on) that usually lasts 2-3 weeks, as well as swelling due to the accumulation of fluid that gradually resolves over a few weeks.
Recovery is usually rapid. Surgery is almost always done as a day case procedure. Pain relief is usually required for the first 2-3 days and most patients are fully recovered by two weeks (keyhole surgery) or possibly three to four weeks (open operation). It is best not to lift heavy objects for about four weeks following the operation so that the mesh can properly bind to the tissues.
Recovery is usually rapid. Surgery is almost always done as a day case procedure. Pain relief is usually required for the first 2-3 days and most patients are fully recovered by two weeks (keyhole surgery) or possibly three to four weeks (open operation). It is best not to lift heavy objects for about four weeks following the operation so that the mesh can properly bind to the tissues.
Anti-reflux Surgery
Reflux is an extremely common condition in the western world as it is often associated with obesity. The symptoms include heartburn/burning behind the breast bone (retrosternal burning) and a sour/bile taste in the back of the throat. Reflux may cause bad breath, hoarseness and coughing.
Treatment is usually medical but the issue can also be addressed surgically. Treatment with antacid medication usually works very well. Loss of weight and not eating before lying down helps to prevent reflux. Smoking may make reflux worse. Surgery may be required if there is an inadequate response to medication, the medication causes side effects or if the patient does not wish to take medication for the rest of their life. The purpose of the surgery is to recreate the valve between the gullet and the stomach to try and prevent stomach acid from refluxing into the gullet. The surgery can be completed as a laparoscopic (keyhole) operation in over 95% of cases. The upper part of the stomach is wrapped around the lower part of the gullet to recreate the valve (gastro-oesophageal junction). A large tube is placed in the gullet to calibrate the tightness of the wrap.
Treatment is usually medical but the issue can also be addressed surgically. Treatment with antacid medication usually works very well. Loss of weight and not eating before lying down helps to prevent reflux. Smoking may make reflux worse. Surgery may be required if there is an inadequate response to medication, the medication causes side effects or if the patient does not wish to take medication for the rest of their life. The purpose of the surgery is to recreate the valve between the gullet and the stomach to try and prevent stomach acid from refluxing into the gullet. The surgery can be completed as a laparoscopic (keyhole) operation in over 95% of cases. The upper part of the stomach is wrapped around the lower part of the gullet to recreate the valve (gastro-oesophageal junction). A large tube is placed in the gullet to calibrate the tightness of the wrap.
Complications include the possible conversion from a keyhole operation to an open operation. If the wrap is too tight, there may be some ongoing swallowing difficulties. If the wrap is too loose, there may be some recurrent reflux. Most patients have some difficulty when swallowing (especially noticeable when consuming bread and meat products) during the first few days after the surgery and this can sometimes last for a few weeks. After six weeks, the patient's diet should not be restricted. For the rest of the patient's life, they usually have to chew food thoroughly and eat relatively slowly. Occasionally the wrap has to be revised by surgery if it is too tight (1% risk). As some of the the stomach is used for the wrap, the size of the stomach is effectively decreased and a feeling of fullness is very common for the first few months after the operation (gas bloat) and will gradually improve over time. Increased flatulence is common after the operation. It is usually possible to belch/burp but difficult to vomit. Occasionally, the wrap can become undone and recurrent reflux can develop. Around 10% of patients will have recurrent reflux and about 10% will have some ongoing swallowing difficulties. In most studies, 80-90% of patients have a good result without recurring reflux and without any significant swallowing difficulties following surgery.
Recovery usually takes around ten days to regain normal function, along with two nights in hospital. It may take a few weeks before swallowing difficulties retreat.
Recovery usually takes around ten days to regain normal function, along with two nights in hospital. It may take a few weeks before swallowing difficulties retreat.
Hiatus Hernia Surgery
A hiatus hernia is a protrusion of stomach into the chest. A sliding hiatus hernia occurs when the stomach pushes through the hole in the diaphragm into the chest with the gullet above it. A para-oesophageal hiatus hernia occurs when the stomach slides alongside the oesophagus. A sliding hiatus hernia usually causes reflux/heartburn. A para-oesophageal hiatus hernia usually causes discomfort in the left chest when eating, difficulty when swallowing and a feeling of fullness after small meals.
Treatment usually involves medication in the form of antacids. If medication does not control the symptoms, surgery is usually required (particularly with a para-oesophageal hiatus hernia). There is a very small risk of the stomach twisting in a hiatus hernia. If this is the case then emergency surgery is required. The procedure is similar to reflux surgery with the addition of pulling the stomach back to its normal abdominal position and repairing the hole in the diaphragm with stitches and sometimes mesh/gauze.
Treatment usually involves medication in the form of antacids. If medication does not control the symptoms, surgery is usually required (particularly with a para-oesophageal hiatus hernia). There is a very small risk of the stomach twisting in a hiatus hernia. If this is the case then emergency surgery is required. The procedure is similar to reflux surgery with the addition of pulling the stomach back to its normal abdominal position and repairing the hole in the diaphragm with stitches and sometimes mesh/gauze.
Complications are the same as for anti-reflux surgery. The major concern (particularly with a large hiatus hernia) is the risk of recurrence (20 - 40% risk). This risk can be reduced with the use of mesh/gauze. There is a concern that the mesh can cause problems with erosion into the adjacent gullet. Losing weight may help to decrease the risk of recurrence.
Recovery usually takes around ten days to regain normal function, along with two nights in hospital. It may take a few weeks before swallowing difficulties retreat.
Recovery usually takes around ten days to regain normal function, along with two nights in hospital. It may take a few weeks before swallowing difficulties retreat.
Achalasia
Achalasia is a rare condition that affects swallowing. Its cause is unknown. It comes on very gradually, and is indicated by a progressive difficulty in swallowing food. The food becomes stuck behind the breast bone and water can be used to wash it down. The problem is due to the valve between the gullet and the stomach failing to relax, as well as a failure of peristalsis or contractions of the gullet which push food down. It is usually diagnosed with a combination of endoscopy and a barium x-ray swallowing.
Treatment involves attempting to open the valve between the gullet and the stomach. This can be achieved through the use of a balloon and endoscopy to stretch the valve and a Botox injection to (usually temporarily) relax the valve. Only surgery can provide long-term improvements. Surgery is usually completed as a keyhole (laparoscopic) operation. This involves dividing the muscle fibres of the valve between the gullet and the stomach, followed by a partial anti-reflux procedur as dividing the valve may allow reflux to occur. Surgery is usually the preferred treatment for most patients.
Treatment involves attempting to open the valve between the gullet and the stomach. This can be achieved through the use of a balloon and endoscopy to stretch the valve and a Botox injection to (usually temporarily) relax the valve. Only surgery can provide long-term improvements. Surgery is usually completed as a keyhole (laparoscopic) operation. This involves dividing the muscle fibres of the valve between the gullet and the stomach, followed by a partial anti-reflux procedur as dividing the valve may allow reflux to occur. Surgery is usually the preferred treatment for most patients.
Complications may occur as with any operation. Occasionally, the keyhole procedure has to be converted to an open operation. By dividing the fibres of the muscle, it is possible to create a perforation/hole in the gullet that may require additional surgery (10% risk). As long as the perforation is picked up during the initial operation, it is usually no major concern. It is important to note that normal swallowing can never be achieved again (as it is not possible to make the gullet contract normally) although surgery will make a substantial improvement. Despite performing a partial anti-reflux procedure, reflux may still be a problem and anti-reflux medication may be required in the future.
Recovery takes two weeks. Two nights are usually required in hospital.
Recovery takes two weeks. Two nights are usually required in hospital.
Surgery for Oesophagael/Gullet Cancer
There are two main types of oesophageal/gullet cancer - squamous and adenocarcinoma. Squamous cancer is usually related to smoking and drinking whereas adenocarcinoma is usually related to chronic reflux. Both types of cancer are usually treated with chemotherapy and/or radiotherapy in combination with surgery. Squamous cancer is usually very sensitive to radiotherapy and the role of surgery is debatable. Oesophageal cancer usually causes swallowing difficulties and a loss of weight.
Treatment depends on the stage of the cancer and whether the cancer has spread. Several tests are used to determine the stage of the cancer and look for signs suggesting that it has spread. If the cancer is localised in the oesophagus and the patient is fit for surgery, a combination of chemo radiotherapy and surgery is usually recommended. This is the best chance of a cure. Chemotherapy and/or radiotherapy is given before surgery over several weeks to shrink the tumour. The surgery is a major undertaking and patients have to be fit for it. Keyhole surgery is usually performed to ensure the cancer has not spread and is then converted to an open operation. It involves an operation through the abdomen as well an operation through the right chest to remove the gullet. The gullet is then recreated using part of the stomach as a tube. Chemotherapy may be required after surgery depending on the final stage of the tumour.
Treatment depends on the stage of the cancer and whether the cancer has spread. Several tests are used to determine the stage of the cancer and look for signs suggesting that it has spread. If the cancer is localised in the oesophagus and the patient is fit for surgery, a combination of chemo radiotherapy and surgery is usually recommended. This is the best chance of a cure. Chemotherapy and/or radiotherapy is given before surgery over several weeks to shrink the tumour. The surgery is a major undertaking and patients have to be fit for it. Keyhole surgery is usually performed to ensure the cancer has not spread and is then converted to an open operation. It involves an operation through the abdomen as well an operation through the right chest to remove the gullet. The gullet is then recreated using part of the stomach as a tube. Chemotherapy may be required after surgery depending on the final stage of the tumour.
Complications are common with any major operation. The most significant complication is leaking from the join between the stomach and the gullet in the chest (anastomotic leak 5%). This may require a return to the theatre and intensive care (ICU). Chest infectionsor pneumonia is common as the lung has to be deflated during the operation. Infection in one of the cuts, bleeding and blood clots can occur. It may take a while for the remaining stomach to start working normally again (delayed gastric emptying). Over a period of several months, the join between the stomach and gullet may need to be stretched with an endoscope (stricture). There is a small risk ofchronic pain in one of the cuts (especially the chest cut). There is a small risk of death from a major operation (1-2%).
Recovery may take a while after any major surgery. One to two nights in intensive care is usually required followed by about ten days in hospital providing there are no significant complications. It usually takes about six weeks for the patient to recover their full strength and up to three to six months to recover to their normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Recovery may take a while after any major surgery. One to two nights in intensive care is usually required followed by about ten days in hospital providing there are no significant complications. It usually takes about six weeks for the patient to recover their full strength and up to three to six months to recover to their normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Surgery for Stomach/Gastric Cancer
Stomach cancer is relatively rare and the cause is unknown. It usually causes a feeling of fullness in the abdomen, loss of weight, and may cause vomiting and bleeding. Often the symptoms are minimal and therefore it is often quite advanced when it is diagnosed. It is usually diagnosed with endoscopy and a CT scan.
Treatment depends on the stage of tumour and how fit you are. It usually involves chemotherapy and surgery. Chemotherapy is usually given before the operation over a period of 9 weeks followed by surgery 4-6 weeks later. Keyhole surgery is usually performed to exclude cancer spread before proceeding onto major surgery. Either part of the stomach or the entire stomach is removed and the stomach is replaced with part of the small intestine. Further chemotherapy is usually given once you have recovered from surgery.
Treatment depends on the stage of tumour and how fit you are. It usually involves chemotherapy and surgery. Chemotherapy is usually given before the operation over a period of 9 weeks followed by surgery 4-6 weeks later. Keyhole surgery is usually performed to exclude cancer spread before proceeding onto major surgery. Either part of the stomach or the entire stomach is removed and the stomach is replaced with part of the small intestine. Further chemotherapy is usually given once you have recovered from surgery.
Complications can be significant with any major operation. The most significant complication is leaking from one of the joins (anastomotic leak 5%). This may require further surgery or intensive care. Bleeding, infection and blood clots may occur. Chest infection is common. A feeling of fullness after eating is common depending on how much of the stomach has been removed and small frequent meals are required for several months. Usually after several months a normal size meal can be eaten. Usually vitamin B12 has to be given by injection every three to four months for the rest of your life as the stomach is required in the absorption of vitamins B12. The chance of death is 1-2%.
Recovery can take a while after any major surgery. 1-2 nights in a high care ward is usually required followed by around 7-10 days in hospital if there are no significant complications. It usually takes about six weeks to recover your strength and up to three to six months to recover to your normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Recovery can take a while after any major surgery. 1-2 nights in a high care ward is usually required followed by around 7-10 days in hospital if there are no significant complications. It usually takes about six weeks to recover your strength and up to three to six months to recover to your normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Surgery for Pancreas Cancer
Pancreas cancer is relatively uncommon but is often diagnosed at a late stage and so surgery is not often possible. The symptoms include loss of weight, jaundice, dark urine and pale bowel motions. Sometimes a dull back pain may be present.
Treatment depends on the stage and how fit the patient is for surgery. A CT scan and several other tests are used. If you are not fit enough for surgery, a stent can be placed in the bile duct by endoscopy to relieve the jaundice. The type of surgery depends on where the tumour is located. Usually keyhole surgery is performed prior to the major open operation. If the tumour is in the head of the pancreas, the operation is a major undertaking and is possibly one of the most complicated operations (Whipples operation). A Whipples operation involves removing the head of the pancreas, the duodenum, part of the bile duct, the gallbladder and part of the stomach. The area is reconstructed using a loop of intestine. The operation can only be completed if the major blood vessels to the intestine are not affected by the cancer and if there are no signs indicating the tumour has spread. The operation takes about four to six hours. If the tumour is in the end/tail of the pancreas, it usually involves removing the end half of the pancreas and sometimes the spleen. Chemotherapy is often required for six months after the operation depending on the final biopsy result. Generally speaking, the only chance of cure is with surgery and chemotherapy.
Treatment depends on the stage and how fit the patient is for surgery. A CT scan and several other tests are used. If you are not fit enough for surgery, a stent can be placed in the bile duct by endoscopy to relieve the jaundice. The type of surgery depends on where the tumour is located. Usually keyhole surgery is performed prior to the major open operation. If the tumour is in the head of the pancreas, the operation is a major undertaking and is possibly one of the most complicated operations (Whipples operation). A Whipples operation involves removing the head of the pancreas, the duodenum, part of the bile duct, the gallbladder and part of the stomach. The area is reconstructed using a loop of intestine. The operation can only be completed if the major blood vessels to the intestine are not affected by the cancer and if there are no signs indicating the tumour has spread. The operation takes about four to six hours. If the tumour is in the end/tail of the pancreas, it usually involves removing the end half of the pancreas and sometimes the spleen. Chemotherapy is often required for six months after the operation depending on the final biopsy result. Generally speaking, the only chance of cure is with surgery and chemotherapy.
Complications can be significant, as with any major operation. The most significant complication would involve any one of the single joins leaking (anastomotic leak). The join to the remaining pancreas is always the most likely to leak (up to 20% risk). Drains are left in place and the joins usually heal, however further surgery and intensive care may be required. Bleeding, infection and blood clots can occur. Occasionally the patient can become diabetic, especially if their remaining pancreas is not normal (5-20% risk). Delayed emptying of the stomach (gastric delay) is common in the first week or two but usually gradually improves. The chance of death is 1-2%.
Recovery will take a while, as with any major surgery. 1-2 nights in intensive care is usually required followed by around ten days in hospital if there are no significant complications. It usually takes about six weeks for the patient to recover their full strength and up to 3-6 months to reach their normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Recovery will take a while, as with any major surgery. 1-2 nights in intensive care is usually required followed by around ten days in hospital if there are no significant complications. It usually takes about six weeks for the patient to recover their full strength and up to 3-6 months to reach their normal energy levels. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Liver Surgery
Liver surgery is usually required for primary liver cancers (hepatoma) or for cancer that has spread from the colon or rectum. Occasionally, liver surgery is required for benign lumps. To satisfy the requirements for liver cancer surgery, there should not be any cancer anywhere else in the body and it needs to be determined whether enough healthy liver can be left in the patient. The patient should also be fit for a major operation. Several tests need to be completed to confirm that the cancer is confined to the liver and to determine its precise location. Chemotherapy may be required after the operation. If the tumour cannot be completely removed, further surgery may be required or the tumour can be destroyed by heating or freezing it. Without surgery, there it is virtually no chance of survival. With surgery, the average chance of cure is in the order of 40%.
Complications can be significant, as with any major operation. The most significant complications include bile leaks and bleeding.Wound infections, chest infections and blood clots are also possible. Leaking bile usually seals itself but endoscopy may be required.Bleeding sometimes requires a return to theatre. Very occasionally, liver failure may develop if the remaining liver is not as healthy as expected. The chance of death is 1-2%.
Recovery can take a while after any major surgery. 1-2 nights in intensive care is usually required followed by around 10 days in hospital if there are no significant complications. It usually takes about six weeks for the patient to fully recover, and up to 3-6 months until their normal energy levels are reached. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Recovery can take a while after any major surgery. 1-2 nights in intensive care is usually required followed by around 10 days in hospital if there are no significant complications. It usually takes about six weeks for the patient to fully recover, and up to 3-6 months until their normal energy levels are reached. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Surgery for Colon Cancer
Colon cancer is common in Australia. Symptoms may include a change in bowel habits, bleeding with bowel motions and a loss of weight. It may be detected through the National Bowel Cancer Screening Program which involves a test for faecal occult blood (blood that cannot be seen in bowel motions). A colonoscopy and CT scan is required for diagnosis and staging.
Treatment requires the partial removal of the bowel and depends on which side the cancer is located. This can usually be performed with keyhole surgery if the size of the tumour and its location is suitable. Chemotherapy may be recommended following the operation depending on the final stage of the tumour. On some occasions, an open operation is required and occasionally a stoma or colostomy (usually as a temporary procedure).
Treatment requires the partial removal of the bowel and depends on which side the cancer is located. This can usually be performed with keyhole surgery if the size of the tumour and its location is suitable. Chemotherapy may be recommended following the operation depending on the final stage of the tumour. On some occasions, an open operation is required and occasionally a stoma or colostomy (usually as a temporary procedure).
Complications can occur with any surgical procedure. An anastomotic leak (where the join between the two pieces of bowel leaks) is the most significant risk (5% risk), and this may require a return to theatre and the creation of a stoma or colostomy. The most common complication is an infection in one of the cuts. If keyhole surgery cannot be performed, conversion to an open operation may be required. Bleeding, chest infections and blood clots can occur and precautions against these complications are taken. Injury to the left ureter (the tube that drains the kidney to the bladder) rarely occurs. Impotence can occur with low cancers of the rectum. Risk of death from any major operation is about 1-2%.
Recovery is usually faster following keyhole surgery and involves a 3-4 night stay in hospital. Following an open operation, 5-7 nights is required provided there are no significant complications. It usually takes about 3-6 weeks for the patient to make a full recovery. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
Recovery is usually faster following keyhole surgery and involves a 3-4 night stay in hospital. Following an open operation, 5-7 nights is required provided there are no significant complications. It usually takes about 3-6 weeks for the patient to make a full recovery. A normal quality of life can be expected after several months. With cancer, depending on the stage, there is always a risk of recurrence.
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