Abdominoperineal Resection in Tunisia

Treatment and Cost

10

Total Days
In Country

2 No. Travelers

5 Day in Hospital

5 Days Outside Hospital

Treatment cost starts from

USD 37500

Hospitals

About the Abdominoperineal Resection

Abdominoperineal resection (APR) is a type of a surgery in which the anus, rectum, and sigmoid colon are removed through small cuts in the belly. It is a surgical procedure done primarily to remove the cancer of the rectum. Typically, abdominoperineal resection (AP) is conducted as an elective procedure. This procedure is most often used to treat rectum cancer if it is located very low in the rectum or in the anus, close to the sphincter muscles.

Nowadays, advanced surgical techniques and other treatment modalities have brought an increase in the rate of sphincter-sparing operations. However, APR surgery is still necessary in selected cases, especially if the patient has distal tumors or poor sphincter function.  AP resection is a major operation. During perineal resection, the rectum, distal colon, and anal sphincter complex are completely removed using both anterior abdominal and perineal incisions. Once the anus and rectum are removed, a permanent colostomy is needed to complete the procedure.

Colostomy brings the colon to an opening at the surface of the skin, which allows the waste to pass out of the body. This new opening is called stoma and usually measures from one to one-and-a-half inches in diameter. A pouch, or a stoma appliance, is needed to be worn at all times. The stoma has no sphincter muscles, so there is no conscious control over the elimination of waste products from the body after the procedure.

How is Abdominoperineal Resection performed?

  • APR surgery starts with the administration of general anaesthesia. This ensures that patient remains asleep during the perineal resection.
  • Then the surgeon makes a small cut near the belly button and inserts a laparoscope. A laparoscope has a tiny camera on one end. It is inserted through the cut so so that the inside can be seen.
  • Once the laparoscopic camera is in the abdomen, the surgeon makes two to five more small cuts in the abdomen.
  • Surgical instruments are inserted through ports placed on these cuts.
  • The surgeon completes several steps before removing the rectum, anus, and sigmoid colon.
  • The surgeon releases the sigmoid colon and rectum from their attachment to the surrounding structures after dividing the main blood vessels that serve the tumour sections of the bowel.
  • The sigmoid colon is separated from the remaining large intestine after the separation.
  • After the sigmoid colon and rectum are removed, the surgeon operates perineal region to cut away the anus.
  • Finally, the anus, rectum, and sigmoid colon are completely removed from the body.
  • After perineal resection, the surgeon creates the stoma. It is known as a colostomy. The stoma is made from one of the surgical cuts usually placed on the left side of the abdomen.
  • To create a stoma, the surgeon removes a small disk of skin from the area around the cut.
  • The open end of the colon is pulled through the cut on the surface of the skin.
  • The surgeon then stitches the stoma in the place and the abdominal cavity is rinsed out.
  • A small drainage tube is inserted into one of the lower surgical cuts. This drainage tube will promote healing of the tissue inside the abdomen.
  • Finally, the surgeon carefully inspects inside the abdominal cavity and the stitches are used to close the cuts.

Recovery from Abdominoperineal Resection

Recovery of the patient depends on individual circumstances and general health of the patient. A patient may be required to stay in the hospital for three to seven days. However, some patients may need more time to recover.

You can walk and stand on the first day after AP resection and resume most of the usual activities shortly after the surgery. In fact, increased activity reduces the risk of blood clots and also improves breathing. A physical therapist will often visit you during your hospital stay and will help regain your strength after the surgery. After getting discharged from the hospital, avoid lifting more than 5 to 10 pounds for 4 weeks, as this allows the incisions to heal. It also decreases the risk of developing a hernia.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Tunisia / Why should opt for Tunisia as a destination for your medical treatment?
Hospitals in Tunisia are developing and trying to meet the international standards of healthcare. Although there is a basic set up in most of the hospitals for treatment in Tunisia, one can still expect scope for improvement. The Ministry of Health, along with the Government of Tunisia is making effective changes for the healthcare sector. The private hospitals in Tunisia are also undergoing a robust change to provide effective healthcare and treatment in Tunisia.

Like most other countries, hospitals in Tunisia have a private and public healthcare system. Hospitals in Tunisia include three levels of care: primary, with a network of 81 clinics and 2091 basic health centers; secondary, with 109 district hospitals; and tertiary, with 33 regional hospitals and 24 modern CHUs, according to MoS figures.
What are the conditions of the hospitals in Tunisia? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety.
In Tunisia, there are no JCI accredited hospitals but 4 private hospitals are certified ISO and OHSAS (Occupational Health and Safety Assessment Series).
Are the doctors/surgeons in Tunisia of the best quality?
The hospitals in Tunisia have seen a constant change in terms of development and technology. Most doctors that are trained in the country understand the needs and requirements of people and are able to diagnose and treat them well. There are various surgeons that fly in from other countries as well to treat patients. This was brought about due to the economic reforms and various expats residing there. The varying levels of health organizations provide reasonable means of treatment for any patient. There are also trained paramedical and emergency service staff in this country.
What is the process for obtaining a medical visa in Tunisia?
Patients who wish to visit Tunisia for medical purposes must contact the Embassy of Tunisia in their home country. One is required to have a valid passport. Those applicants must submit their visa application forms in person together with the following documents:
  1. A duly completed application form with one picture (within a white background).
  2. Original biometric passport and one copy. Passports should have a validity of at least one year from the date of your visa application submission.
  3. Medical certificate stating the type of illness and the treatment to be carried out. This document has to be in English or Spanish language.
  4. Letter from the hospital in Tunisia stating the appointment date and whether the treatment expenses have been already paid in full.
  5. Proof of financial means which enable the applicant to meet life needs while in Tunisia (salary certificate if working, bank statement for the last six months, property deeds, commercial license, other sorts of income).
  6. Travel insurance.
  7. Proof of accommodation (hotel reservation, etc)
  8. Applicants are advised that ALL PASSPORTS HAVE TO REMAIN at the Embassy premises while the visa application is under process (between 10 and 15 days), and therefore cannot be retrieved unless very special and urgent circumstances might arise.
  9. The Embassy has the right to require from the applicant any document that it may deem relevant in order to resolve the visa file.
What support services does MediGence provide in Tunisia?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
  • 360-degree Hospital Review
    We give you a transparent and holistic view of the hospital and its infrastructure, accreditation, facilities, and expertise to give you confidence.
  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Tunisia for medical treatment?
Tunis is the largest country and capital of Tunisia. This country is located in the northern region of Africa and is the best city for treatment in Tunisia.

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