Three or more small (5-10 mm) incisions are made in the abdomen to allow access ports to be inserted. The laparoscope and surgical instruments are inserted through these ports. The surgeon then uses the laparoscope, which transmits a picture of the abdominal organs on a video monitor, allowing the operation to be performed.

Laparoscopic intestinal surgery can be used to perform the following operations:

Proctosigmoidectomy Surgical removal of a diseased section of the rectum and sigmoid colon. Used to treat cancers and noncancerous growths or polyps, and complications of diverticulitis.

Right colectomy or Ileocolectomy During a right colectomy, the right side of the colon is removed. During an ileocolectomy, the last segment of the small intestine - which is attached to the right side of the colon, called the ileum, is also removed. Used to remove cancers, noncancerous growths or polyps, and inflammation from Crohn's disease.

Total abdominal colectomy Surgical removal of the large intestine. Used to treat ulcerative colitis,Crohn's disease, familial polyposis and possibly constipation.

Fecal diversion Surgical creation of either a temporary or permanent ileostomy (opening between the surface of the skin and the small intestine) or colostomy (opening between the surface of the skin and the colon). Used to treat complex rectal and anal problems, including poor bowel control.

Abdominoperineal resection Surgical removal of the anus, rectum and sigmoid colon. Used to remove cancer in the lower rectum or in the anus, close to the sphincter (control) muscles.

Rectopexy A procedure in which stitches are used to secure the rectum in its proper position. Used to correct rectal prolapse.

Total proctocolectomy This is the most extensive bowel operation performed and involves the removal of both the rectum and the colon. If the surgeon is able to leave the anus and it works properly, then sometimes an ileal pouch can be created so that you can go to the bathroom. An ileal pouch is a surgically created chamber made up of the lowest part of the small intestine (the ileum). However, sometimes, a permanent ileostomy (opening between the surface of the skin and the small intestine) is needed particularly if the anus must be removed, is weak, or has been damaged.

Your surgeon will meet with you to answer any questions you may have. You will be asked questions about your health history and a general physical examination will be performed. Your intestine will require cleaning and you will be given a prescription for a laxative medicine to take the evening before the surgery.

All patients are generally asked to provide a blood sample. Depending on your age and general health, you may also have an ECG (electrocardiogram), a chest X-ray, lung function tests, or other tests. You may also need to meet with another doctor before surgery.

Finally, you will meet with an anesthesiologist, who will discuss the type of pain medication (anesthesia) you will be given for surgery, and you will learn about pain control after the operation.

The evening before surgery you will need to take the prescribed laxative medicine. It is important to follow the directions carefully and drink all of this medicine. This step will decrease your risk of developing an infection from bacteria normally present in the intestine.

Do not eat or drink anything by mouth after midnight the evening before surgery.

An intravenous (IV) tube will be inserted into a vein in your arm to deliver medications and fluids. You will be taken to the operating room when it is available and ready.

When you arrive in the operating room, the nurses will help you onto the operating table. The anesthesiologist will inject medicine into your IV that will put you to sleep. After you are asleep, the nurses will clean your abdomen with antibacterial soap and cover you with sterile drapes.

Your surgeon will place a small port just below your bellybutton and advance the port into your abdominal cavity. This port is connected to sterile tubing and carbon dioxide is passed into the abdominal cavity through the tubing. The gas lifts the wall of your abdomen away from the organs below. This space will give your surgeon a better view of your abdominal cavity once the laparoscope is in place. The laparoscope is placed through the port and is connected to a video camera. The image your surgeon sees on the laparoscope is projected onto video monitors placed near the operating table.

Before starting the surgery, your surgeon will take a thorough look at your abdominal cavity to make sure that laparoscopy will be safe for you. Some reasons why laparoscopy may not be done include multiple adhesions (scar tissue from previous surgery), infection or other abdominal diseases.