The Colon Club

Anyone had this. I have a mid-rectum tumor that most mostly killed off with chemo. I'm having robotic surgery Monday that will remove most of my rectum but the surgeon says there's enough to stitch everything back together. He's doing this robotically, which I understand will help some, but it's still going to suck. Anyone have any similar experience?

I had a robotic LAR on June 14th. I was out of the hospital on June 17th. I had minimal pain, even in the hospital. By the last day, I had not asked for pain meds at all. I currently have a temporary loop ileostomy and am going through chemo. I feel that my surgery was very successful, for what I have experienced so far.

If there is enough rectum left, as your surgeon said, robotic or not, a straight connect, has some getting used to. The key is if your sphincters, are intact. These are the muscles, that can hold your rectum together, until you have time to evacuate comfortably . With a reduced size rectum, your competency to hold waste may take a few years to rebuild. A straight connect will alter after time, and stretch to accommodate waste, but it takes a few years, and then may not be perfect. I wish I would have had an option like yours, 6 years ago, butt I'm alive 6 years later to comment !

Michael

Well, said awkward as it is to type this, the drs. said, welI I can't remember the exact terminology, but the import is that I have a very tight sphincter. Can barely tolerate a finger exam.

Aqx99 wrote:I had a robotic LAR on June 14th. I was out of the hospital on June 17th. I had minimal pain, even in the hospital. By the last day, I had not asked for pain meds at all. I currently have a temporary loop ileostomy and am going through chemo. I feel that my surgery was very successful, for what I have experienced so far.

Anne, you are my new favorite person. I was told to expect a three day hospital stay.

Good luck, I had robotic LAR at MSKCC two years ago. I was in the hospital for 5 days, and then recovered at home for a few weeks. I did not have a temp ileostomy.

The worst part for me was illeus post surgery. Very painful cramping. Heating pads helped and toradol seemed to help too. Took about two days for it to go away.

I had Robotic Assisted LAR post surgery - pre chemo.
I don't really know if it was helpful for the Robotic assist or not.
What I can say is that surgery went pretty well. Even though I had robotic, they still had to give me a large c-section like incision.
This is where they removed the tumor, mine was close to 5 inches in length. They removed 8.2 inches of combined colon/rectum.
Only about 2 inches of my rectum was removed. I had very little pain post surgery. The only time I was in pain was during movement, especially anything that involved stomach muscles.
My advice, use your upper body/arm strength to lift yourself up without using the stomach muscles. I only took 1 pain pill post surgery on first day home.
I spent 4 days in hospital, although they told me I could go at day 3 - but I still had a drain in so wanted to wait for that to come out - which it did the following day.

As for bowel activity. The more rectum removed, the more issues there are with post surgery bowel movements.
I'm now 3 months and 11 days post surgery. My bowels have improved, especially during first 5 days of chemo treatment. I get slightly constipated and have only 1 or 2 movements a day.
Come day 6/7 it starts to get back to 5-8 for a few days as chemo is leaving the body. Then last few days its 3-6 movements a day usually. Right after surgery after coming home I was experiencing 12-16 movements a day. Yeah, really, that's a lot of time on the pot! I had a very hard time for about 5 weeks even going as the surgery internal swelling seemed to block off the colon area when sitting. I literally had to stand/squat during that time. Thankfully I've been able to sit since about 5 weeks. If you need to slow things down Imodium does help. I take a pill the night before, if I know I need to go somewhere the following day without having to be worried about mad dashes to the can.

The first few days after surgery, my stomach was really bloated - I was concerned as I was relatively flat stomached prior, but after a few weeks the swelling decreased and now I'm back to flat stomach - in fact probably flatter than pre surgery as I've lost about 20 lbs - 10 around surgery and 10 since chemo.

Good luck Basil,
May your surgery go smooth and you awaken to little to no complications.

My surgeon had an interesting view on the different ways of approaching a U/LAR case. His view was that some surgeons preferred robotic because the robot had articulated joints and it was more akin to traditional open surgery. So if a surgeon trained a lot via open procedures, she/he would have an easier time moving to a robotic procedure. In fact (again, this is just his opinion), he flat out said that most of the older surgeons leaned toward robotic surgery while the younger surgeons preferred a straight lap procedure since that was the focus of their training. I had a laparoscopic ULAR plus temporary ileostomy. It took about 5 hours. He did hand sew my colon to my anus through my anus so I guess that was a bonus procedure. 4 nights in the hospital. Participated in the ERAS (Enhanced Recovery After Surgery) protocol. No pain killers other than Tylenol. Surgery on a Tuesday. At Costco on Sunday. Back to work ~2 weeks after surgery. I thought the ileostomy reversal was a slightly more difficult recovery. Good luck.

I had a robotic APR plus iliac node dissection done 8/12/2015. I had only mild post op pain and was able to walk down 7 flights of stairs just 3 days post op. I know that without the robotic approach it would be difficult for the surgeons ( I had both a urologist and a colorectal surgeon) to access and remove all the nodes of concern. I was a little concerned this was more a gimmicky technology looking for a use, but now, after my speedy and pain free recovery I am a believer for sure.

benben wrote:I had Robotic Assisted LAR post surgery - pre chemo.
I don't really know if it was helpful for the Robotic assist or not.
What I can say is that surgery went pretty well. Even though I had robotic, they still had to give me a large c-section like incision.
This is where they removed the tumor, mine was close to 5 inches in length. They removed 8.2 inches of combined colon/rectum.
Only about 2 inches of my rectum was removed. I had very little pain post surgery. The only time I was in pain was during movement, especially anything that involved stomach muscles.
My advice, use your upper body/arm strength to lift yourself up without using the stomach muscles. I only took 1 pain pill post surgery on first day home.
I spent 4 days in hospital, although they told me I could go at day 3 - but I still had a drain in so wanted to wait for that to come out - which it did the following day.

As for bowel activity. The more rectum removed, the more issues there are with post surgery bowel movements.
I'm now 3 months and 11 days post surgery. My bowels have improved, especially during first 5 days of chemo treatment. I get slightly constipated and have only 1 or 2 movements a day.
Come day 6/7 it starts to get back to 5-8 for a few days as chemo is leaving the body. Then last few days its 3-6 movements a day usually. Right after surgery after coming home I was experiencing 12-16 movements a day. Yeah, really, that's a lot of time on the pot! I had a very hard time for about 5 weeks even going as the surgery internal swelling seemed to block off the colon area when sitting. I literally had to stand/squat during that time. Thankfully I've been able to sit since about 5 weeks. If you need to slow things down Imodium does help. I take a pill the night before, if I know I need to go somewhere the following day without having to be worried about mad dashes to the can.

The first few days after surgery, my stomach was really bloated - I was concerned as I was relatively flat stomached prior, but after a few weeks the swelling decreased and now I'm back to flat stomach - in fact probably flatter than pre surgery as I've lost about 20 lbs - 10 around surgery and 10 since chemo.

Good luck Basil,
May your surgery go smooth and you awaken to little to no complications.

That sounds overall pretty smooth - a PITA but that's what we're all dealing with. I don't know whether or not my surgeon uses Robotic assist but I will have no objections if she does.

My surgeon is the section chief of colorectal surgery at MDAnderson. The proof is in the pudding, so to speak, but based on my course of treatment I have the utmost respect for his judgment. I hope his resume supports his skill with a scalpel, and the robotic stuff.

Basil wrote:My surgeon is the section chief of colorectal surgery at MDAnderson. The proof is in the pudding, so to speak, but based on my course of treatment I have the utmost respect for his judgment. I hope his resume supports his skill with a scalpel, and the robotic stuff.

Someone once told me, if you're going to have cancer, Houston is your best bet for survival. I have a lot of respect for the strides MD Anderson has made in respect to cancer , not only in Houston, but achievements that affect the whole world.
I would trust you are in excellent hands !
Michael

Surgery is at three tomorrow. I'm very hungry. Nervous as hell too. But it must be done of course.

Basil wrote:Well, said awkward as it is to type this, the drs. said, welI I can't remember the exact terminology, but the import is that I have a very tight sphincter. Can barely tolerate a finger exam.

Perhaps it would be a good idea to obtain an accurate, official pre-surgery baseline measurement of your sphincter strength so that you have something to compare with after surgery in case there are problems later on due to nerve damage or trauma during surgery.

There are several ways to measure sphincter strength using ano-rectal manometers.

http://www.healthcommunities.com/digestive-system-tests/anorectal-manometry-motility.shtml

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