What is an abdominoperineal resection?
An abdominoperineal resection is a surgery in which the anus, rectum, and
sigmoid colon are removed. This procedure is most often used to treat cancers
located very low in the rectum or in the anus.
Once the anus and rectum are removed, a colostomy is created. A colostomy
involves bringing a portion of the colon (large bowel) to an opening at the
surface of the skin. This new opening, called a stoma, allows waste to pass out
of the body. The stoma usually measures from 1 to 1½ inches in diameter. A
pouch, or stoma appliance, is worn to collect stool and gas from the colostomy.
This pouch is worn at all times since there is no longer conscious control of
the elimination of waste products from the body.
You will likely experience many emotional and physical adjustments after
surgery. It will take time to cope with all of these changes, especially the
colostomy. At times, you may feel overwhelmed. Your enterostomal therapist (ET),
a nurse who is specially trained in the care of the stoma, will explain the
stoma to you and provide you with additional reading materials or websites to
help you learn more. Do not hesitate to call your ET nurse after surgery for
further support. There are also support groups in some communities that can
provide additional assistance.
What happens during the surgery?
Laparoscopic surgery allows the surgeon to perform the entire operation through
small openings (keyhole incisions) in the abdomen. This approach - called
"minimally invasive" surgery - avoids the need to make a large incision in the
abdomen. Through these small openings, trocars (ports) are placed. A
laparoscope, which is a small camera, is inserted into the abdomen through a
port near the navel. The laparoscope lets the surgeon see the inside of your
abdomen on a TV screen. The surgery is then performed by inserting surgical
instruments through the other ports in the abdomen. An abdominoperineal
resection is completed in four main steps:
Step 1: Positioning the laparoscope
Once you are asleep, the surgeon makes a small cut (about 1/2 inch) near the
navel. The laparoscopic camera is inserted into the abdomen through a port in
this incision. Images from the laparoscopic camera are projected onto video
monitors placed near the operating table.
Once the laparoscopic camera is in the abdomen, the surgeon makes two to five
more small incisions. Surgical instruments are inserted through ports placed in
these incisions.