Laparoscopic Colectomy in Netanya and Tel Aviv: Colon Surgery

Laparoscopic colectomy is the removal of a diseased segment of the colon through small incisions, with the bowel reconnected afterwards. I perform these operations in Netanya and Tel Aviv for colon cancer, diverticulitis and its complications, polyps that cannot be removed endoscopically, and inflammatory bowel disease.

When surgery is needed

• Colon cancer, including locally advanced disease.
• Diverticulitis and its complications.
• Polyps that cannot be removed during colonoscopy.
• Inflammatory bowel disease.
• Urgent situations in which surgery cannot be delayed.

Which operations I perform

Right and left hemicolectomy, sigmoidectomy, anterior resection, and subtotal and total colectomy. I perform all of these laparoscopically whenever possible; I do not use a robot. The extent of resection depends on the diagnosis and on the location of the tumor or disease.

In cancer surgery I follow oncologic principles: complete mesocolic excision, high ligation of the vessels and D2 lymph node dissection.

I most often create the anastomosis with a stapler, close the technical openings by hand and add reinforcing sutures. A protective stoma is almost never needed, though it may be required in emergency surgery.

Tests and preparation

Before surgery you have a colonoscopy with biopsy, a CT scan and tumor markers, and, when needed, a consultation with an oncologist or gastroenterologist. For surgery on the left side of the colon, mechanical bowel preparation is required. Blood thinners must be stopped in advance; I will tell you exactly when.

How the operation goes

The operation is done under general anesthesia through small incisions. The diseased segment of bowel is removed (in cancer surgery, together with the lymph nodes and the vascular pedicle), and the ends of the bowel are then joined with an anastomosis.

Recovery

The hospital stay is three to five days, depending on the extent of the operation and your recovery. We follow an enhanced recovery (ERAS) protocol. Eating begins once the bowel starts working (you pass gas) and is advanced gradually. Return to work and sports follows the usual timeline after laparoscopic surgery. The follow-up visit is after one month.

Oncologic treatment

I perform the surgery, and if chemotherapy is needed, an oncologist manages it. I always discuss each case at a multidisciplinary tumor board. The pathology result is usually ready in about three weeks, and further treatment depends on it.

Risks

Like any operation, colectomy carries risks: anastomotic leak, bleeding, infection, hernia, impaired bowel function, injury to adjacent organs and thrombosis. I discuss each of them with you in advance.

Where and how it is covered

Surgery is performed at Laniado Hospital (public healthcare) and at the private hospitals Assuta, Herzliya Medical Center and Raphael. Coverage depends on your health fund and insurance. I work with Maccabi, Leumit (Shaban), Clalit (Mushlam), Menora, Ayalon and Clal. Patients with other insurers are welcome for a consultation; I operate only under policies unchanged since 2016.

FAQ

Will I need a stoma?
Usually not. A stoma may be needed in emergency surgery; we discuss all the details in advance.

How soon will I go home?
Usually after three to five days, depending on the extent of the operation and your recovery.

Will my bowel movements change?
At first the stool may be loose or watery, and then the bowel adapts. Sometimes medication such as loperamide is needed.

Will I need chemotherapy?
That depends on the pathology result. The decision is made at the tumor board together with the oncologist.

Can I avoid surgery?
That depends on the diagnosis: some polyps can be removed during colonoscopy. When that is not possible, and in cancer or complicated diverticulitis, we decide at the consultation.

See also

Small bowel resection · Diagnostic laparoscopy · Appendectomy