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Highlights:
- Colon and Rectal resections with minimally invasive approach and excellent outcomes
- Fewer and smaller incisions than standard robotic or laparoscopic technique
- Avoid Ostomies (‘Bags’) in elective resections
- Get Back to your life faster
Dr. Johnson’s Colon Resection Outcomes
- Complication rate below national average:
- Avoiding complications gets you back to life faster.
- This low complication rate is despite a patient population predicted to have higher complication rate (ASA 3+ 78%).
- Length of stay in hospital and return of bowel function far superior to national averages, even for other robotic surgeons.
- Unplanned ostomy rate in non-emergent surgeries under 2%.
- Oncologic outcomes with Lymph Node harvest and negative surgical cancer margin rate superior to national average.
- Book your consult today to discuss predicted statistics for your individual situation.
Robotic Advantage
By utilizing the full capabilities of the Davinci Robot, Dr. Johnson can resect and sew back together your colon/rectum using robotic arms through 8mm incisions, and potentially even extracted through the rectum.
We then add an advanced Early Recovery After Surgery (ERAS) Program that focuses on the all other aspects of Colorectal surgery recovery.
Together these are all crucial in the recovery process, allowing patients to ambulate sooner, with less pain, take fewer narcotic pain medications, and take deep breaths.
Ultimately this modern approach to colorectal surgery leads to less complications, shorter stay in the hospital, and gets you back to your life, faster.
Avoiding Colostomy/Ostomy
Many patients fear having a colostomy bag after Colorectal surgery. Rest assured Dr. Johnson will give you the best chance at avoiding this, unless necessitated for your safety.
In scheduled Colon or Rectal resections, Dr. Johnson’s rate of requiring an ostomy is less than 2-3%, and a majority of these patients are re-connected a few months later.
This is accomplished with a very low leak rate from the bowel anastomosis (connection).
This is accomplished by utilizing robotic technology with tireless focus on surgical technique.
Ostomy bag after resection of sigmoid colon
Ostomy Reversal
If you have an ostomy currently, Robotic ostomy reversal is a great option. The vision and dexterity of the robotic instruments shine in narrow spaces such as the pelvis where anastomosis typically occurs. Many patients that have a colostomy from emergent open surgeries at other hospitals come to Dr. Johnson to re-connect the bowel.
Natural Orifice Extraction
Appropriate Colon and Rectal specimens can be extracted through the rectum (A natural orifice) saving the patient a 5-10 cm incision previously required with laparoscopic surgery, and nearly all robotic surgeries in the United States.
This is facilitated by Dr. Johnson’s ability to sew the bowel connection robotically.
If an extraction incision is required, Dr. Johnson typically places this incision in the underwear line. This location hides this larger incision, when required, and places it in a location much less prone to developing a hernia in the incision.
This leads to less pain and potential for incisional complications.
Incisions for Robotic Sigmoid with natural orifice extraction
Typical incisions after laparoscopic sigmoid colon extraction
Intracorporal Anastomosis
The dexterity of the robotic instruments allows Dr. Johnson to sew in a similar fashion to open surgery. This allows re-connecting (bowel anastomosis) without exteriorizing bowel or using bowel staplers.
Typically in laparoscopic surgery, an additional bowel is dissected free, brought out of an incision in the mid abdomen, connected outside of the body (extracorporeally), and put back into the abdomen.
These newer Robotic techniques avoid tissue trauma to the bowel, leading to faster recovery of bowel function.
Most of Dr. Johnson’s patients see return of bowel function within 1-2 days of surgery, leading to the average hospital stay after colon or rectal surgery of 2.3 days post-op.
In the past these types of connections have had higher leak rates, but by ensuring no tension on connections, proper blood flow at connection, proper nutrition, and sewing of bowel rather than using staplers, you can avoid an ostomy, and benefit from an exceptionally low leak rate.
Advanced ERAS (Early Recovery After Surgery) Protocols
Improving outcomes of Colorectal Surgery is multifaceted. This program focuses on reducing complications and getting back to your life based on evaluation of evidence based medicine across all aspects of colon surgery. It standardizes the pain regimen, DVT prophylaxis, methods for avoiding infections, nutrition, early walking and several other data driven aspects of peri-operative care.
Dr. Johnson has led the adoption of this program across his hospital system.
The ERAS program starts during the Pre-op clinic visit with informational packets and consultation given to patients, so patients know what to expect.
There is even a grant for to provide free Pre-op nutritional Supplements to qualifying patients, and a plan for early feeding with liquids the same day of surgery
Non-narcotic pain regimen and anticoagulation begins in pre-op to prevent pain and complications through non-opioid analgesics and Anesthesia ultrasound guided pain blocks
Combining this program with optimal surgical techniques lead to the outcomes shown.
ERAS protocols integrate with advanced robotic techniques to reduce complications and decrease recovery time.
What to Expect:
It is normal to be scared with the idea of surgery. Patients report feeling much better after their clinic appointment.
Before Clinic write down questions, bring relevant health records from out of network facilities. Review med list.
Discuss Goals, concerns and questions.
Discuss treatment options with expected timelines and predicted outcomes statistics based on Dr. Johnson’s individual data.
Improve your outcomes by optimizing your health before surgery.
Smoking Cessation – quitting nicotine products 4 weeks prior to surgery reduces risk of complications.
Nutrition – even with cancer diagnoses, your body needs the nutrients to heal, which has been proven to reduce recovery times.
Reduce processed foods and sugars.
If you cannot afford proper nutrition, Dr. Johnson’s team has a grant to provide that for you.
Weight – BMI <35 associated with decreased complications.
Diabetic control – A1C <7.5
You will meet with Dr. Johnson, the anesthesiologist and surgery team in the pre-operative area.
We will go over final questions and expectations including timeline.
Your family can be with you at this time.
Pre-operative pain management to get ahead of the pain.
This is the nerve-wracking portion for every patient.
Rest assured you are in the best hands.
Family will be updated during the surgery if we need to take more time than is predicted.
Every patient is different inside and out.
Safety and surgical outcome are the primary concern.
Close monitoring as patient comes out of anesthesia.
Family updated on surgical findings.
Pain control.
Early Recovery After Surgery (ERAS) protocols followed.
Clear liquids day of surgery.
Up out of bed day of surgery or at latest day after surgery.
Work toward discharge goals:
- Return of bowel function (passing flatus have a bowel movement.
- Acceptable pain control at rest and walking
- Tolerating general diet
This is your time to heal and recover.
Dr. Johnson recommends taking 2 weeks off work for recovery of colon surgery.
No lifting more than 15 pounds to prevent hernias.
Walking, stairs and low impact activities are encouraged.
Avoid irritating foods such as spicy or fried foods as well as raw, stringy vegetables.
Stool softeners to counteract constipation from narcotic pain meds (if using).
No lifting more than 30 pounds or focused abdominal exercises.
Return to work with weight restriction.
Completely normal diet unless instructed.
Off of pain medications.
Bowel function should be normal.
Patient Reviews
Dr. Benjamin Johnson is a genuine person to the core. I have gone through about 30 big and small surgeries in my life, and he is one of the top two surgeons I have ever met. Surgery of any kind is a fusion of skill and art; Dr. Johnson has clearly mastered that. He is also an extremely knowledgeable doctor who can simplify complex medical conditions to patients. I'd be recommending him to anyone who asks me for suggestions on where to get general surgery or surgeries in his areas of clinical interest. As an experienced surgery patient with a good sample size of doctors and their work, I can
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I would highly recommend Dr. Benjamin Johnson. He is an exceptional physician. I was referred to Dr. Johnson for a second opinion after getting conflicting advice following a first hospitalization for diverticulitis. I had one doctor who was insisting I needed an immediate colon resection surgery and another who was focused on some other findings relative to my bile & pancreatic ducts. Needless to say, I was confused and frustrated on top of not feeling well. Dr. Johnson was more helpful than both of the other doctors combined. He is extremely knowledgeable, very caring and patient. He expl
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Specializing in Robotic Surgery Services in Chicago
Dr. Johnson’s Commitment to treating the whole patient, top surgical skills, and recovery programs have led to proven excellent outcomes with Robotic Surgery.
Specializing in Robotic Surgery In Chicago
Dr. Johnson’s Commitment to treating the whole patient, top surgical skills, and recovery programs have led to proven excellent outcomes with Robotic Surgery.
