Choosing a surgeon for ileocolectomy?

[GraivyTrain]

I have had crohns disease for 10+ years. I was hospitalized for an abscess and infection twice recently and now my GI doctor (and 2nd opinion GI doc) are suggesting I have surgery. I have an area with 3 fistulas that needs to go. They referred me to a general surgeon and he said the following:

1. He would remove a portion of my small intestine and colon (ileocolectomy).
2. The surgery would be laparoscopically assisted. He said the camera would go in a small incision to the left of my belly button, a tube in a small incision to the right, then a 5-7 inch incision in my lower abdomen. I think the reason for this incision size is they need to remove a bunch of diseased tissue. Also, this allows them to actually see things better and use their hands especially since I currently have some inflammation.
3. It is very unlikely that I would need a temporary ileostomy bag.
4. Hospital stay would be 4ish days, 2-3 weeks before going back to work.

I have a tentative surgery date scheduled for October 1st, but have a few questions/concerns.

1. This is a general surgeon who specializes in a lot of GI related procedures. I feel like it would be best to at least talk to a colorectal surgeon and get their opinion as well. Has anyone had good/bad results with general surgeons as apposed to specialists?
2. Why not do the surgery laparoscopically with a few tiny incisions, instead of having the large one? I think this is because they need to pull stuff out, but 5-7 inches seems very large right? What are your scar sizes?
3. How to be sure you choose the right surgeon? I feel like my consultation went really well, the general surgeon was very confident, has performed these procedures many times and has been doing this for 20+ years, but I am still hesitant. Maybe just talking to another colorectal surgeon would ease my thoughts? Also, if I talk to another surgeon and they say essentially the same thing, should I just choose the specialist over the general surgeon?

Thanks in advance for any insight.

 

[DJW]

Hi and welcome.

Sorry I've got no advice.

Back to work in 2-3 weeks? WOW! what type of work do you do?

 

[GraivyTrain]

I'm an application developer so I just sit at a desk and type on the computer all day... which is good in this case, no heavy lifting or moving around really. And 2-3 weeks is being optimistic. ;o)

 

[DJW]

Glad you have a desk job.

I should add heavy is 10 pounds or more. Lol

 

[DEmberton]

Have you double-checked the 5-7 inches? That's huge, maybe it should be 5-7cm?

I have about a 1 inch scar down from my belly button, and 3 tiny maybe 1/4 inch scars: one above, one to the left, one below. That was to remove 20cm of terminal ileum.

They let me out after 4 days in hospital (instead of the 5 they'd planned). I was told beforehand I'd need 6 weeks off work, wouldn't be able to lift anything heavier than a kettle, and wouldn't be able to drive for a month. But in reality I took about a week and a half, then worked at home for a few days until I got bored and decided I wanted to get back to normality (I'm also a code monkey).

I understood the main reason for the quick recovery was the small incisions.

 

[GraivyTrain]

You're right, it was 5-7cm.

Actually, I ended up talking with another colorectal specialist and have chosen him to do my surgery on October 1st at Yale in CT. He was much more thorough than the General Surgeon and is going to do the procedure laparoscopically, the abdomen incision should be 3-4cm and all the stitching will all be done inside. He said it is unlikely I will need a bag. I just need to get off of these steroids prior to the surgery to prevent complications in recovery. I can't wait to get this over with.

 

[DEmberton]

Glad to hear it. Hope it all goes well for you. I got very frustrated waiting for the surgery, but it was well worth it.