Reattachment After Colon Cancer Surgery
The goal of the second operation was reattachment of the colon to the rectum and implantation of a port to be used later for introduction of the chemicals associated with chemotherapy.
Preparation for this surgery was
extensive. It included
o blood tests
o pre-op visit to primary care-giver
o pre-op visit to surgeon
o forms, forms, forms, forms
o diet, diet
o antibiotics (flush)
The operation was scheduled for a Friday. On Tuesday I was allowed what is called a full liquid diet, characterized by such things as ice cream, cream of rice, and tomato soup. On Wednesday and Thursday I was on clear liquids - broth, jello, and ginger ale.
Thursday afternoon I had a whole cocktail of antibiotics over a few hours. Intentional or not, the result of the diet and the antibiotics was a pretty complete flush of my digestive system. Through the evening and night, I'd guess two quarts of fluid came out. By the end of that session, I think I presented a pretty clean system to the surgeon.
The surgeon went in through virtually the same wound as with the original surgery, although I think he may have started 1 1/2" lower and finished about the same amount lower. A close examination of the staples in the following pictures shows this difference at the top of the wound. This sequence was taken soon after I was discharged from the hospital.
This picture shows the implanted port on the upper chest, the entry wound down the middle of the abdomen, and the colostomy closure. The port is covered in detail in a separate section.
From left to right on the picture, see the ancient appendectomy scar with the newer cecostomy scar on top of it, the entry wound closed with staples, and the colostomy closure closed with staples.
This picture focuses on the colostomy closure. The redness beneath the wound is probably skin reaction to the ever-present adhesive (but may also be the surgeon's initials).
As I understand it, the stoma was removed from its attachment to the abdomen, appropriately trimmed back to viable material, the same was done with the dormant section of colon that had been sutured, and the two ends were connected with staples. The connection was tested with air pressure for any leaks (yeah, this is not a joke). Both the entry wound and the colostomy closure wound were closed with sutures on the inside and staples on the outside.
The port was implanted and its catheter was threaded through minor vessels into the vena cava. The end of the catheter is trimmed to dump very near the heart where blood quantity quickly dilutes the chemicals. Those wounds were closed with stitches.
The surgeon scheduled several hours for these procedures, but accomplished everything including his signature in less than two hours.