Intestinal Surgery

Intestinal Surgery

What is Colon Resection?

Colon resection is surgery to remove part of the large bowel. The large bowel, also called the large intestine or colon connects the small intestine to the anus and is part of the digestive tract. During colon resection, the diseased or damaged section of the intestine is removed and the two healthy sections of the colon are reattached.

Who are candidates for Colon Resection?
Large bowel resection is used to treat a variety of conditions, including:

Colon cancer
Diverticular disease – when small sacs or pouches that develop in the colon become chronically infected and inflamed.
Intestinal blockage caused by scar tissue

Bowel resection may also be performed for these conditions:

Ulcerative colitis – a form of inflammatory bowel disease that causes swelling and ulcerations.
Traumatic injuries
Precancerous polyps – swollen thick membranes that grow on the lining of the colon that may eventually cause cancer.
Familial polyposis – an inherited condition in which polyps (swollen thick membranes) develop on the lining of the colon.

Depending on the type of resection, a colostomy may be required. A colostomy is a surgical opening made through the abdomen to allow a path for elimination of waste. It may be a temporary or permanent condition to allow the colon to heal. A colostomy may be required under these circumstances:

Intra-abdominal infection, such as perforated diverticulitis
Injury to the colon or rectum (for example, a gunshot wound)
Rectal cancer
Perineal wounds or fistulas – abnormal connections between that occur between parts of the intestine

What is the Colon resection recovery process?
The length of your hospital stay will depend on the type of procedure. In general, you can expect the following:

You will have sutures (stitches) or metal clips (staples) to hold your incision together with gauze bandages covering the incision. Stitches under the skin dissolve, but in almost all cases you will have to have some sutures or staples removed about seven to ten days after surgery.
You may need assistance standing up, but you will be encouraged to walk around your room and to the bathroom.
You should expect to stay in the hospital two to seven days following the procedure at which time the medical staff will evaluate your pain levels, fluid intake, increase walking/sitting times and getting nutrition by mouth.
Your activity should be limited for a couple of weeks. Your body will need almost two months to return to a normal activity level. Walking and other gentle activities are very important to regaining your strength. Avoid any strenuous physician activity such as heavy housework such as vacuuming, until approved by your physician. Do not lift anything heavier than 5 kgs for at least six weeks after surgery. Walk a little more each day.
The diet recommended by your doctor, drink plenty of fluids and do not take laxatives unless approved by your doctor.

What are alternatives to Colon Resection?
Depending on your condition, alternative treatments may be available. Medications to treat particular conditions may be advised. Discuss with your physician if there are alternative treatments that would be appropriate for your situation.

What is the small bowel?

The small bowel is the upper part of the bowel, beyond the stomach. It is narrower than the large bowel, which it joins in the right hand side of the tummy near the appendix. It is about 5 meters long.
The small bowel starts in the right side of the tummy, where it is called the duodenum, which is about 20cm long. The next 250cm or so of the small bowel is called the jejunum. The rest of the small bowel is called the ileum. The ileum joins the large bowel at the lower right of the tummy, near the appendix.
What is the problem?

Part of your small intestine, also known as your small bowel, is diseased. You need to have this part of the bowel removed and the bowel ends joined together.
What has gone wrong?

The most common reason for a small bowel operation is a blockage. This is usually due to scarring, called adhesions, or a rupture, called a hernia. The bowel may simply be pressed on, at one point. This makes the bowel above the obstruction swell up. The food and digestive juices build up, causing vomiting and loss of water and salts from the body.

If a loop of bowel becomes trapped or twisted, it will obstruct the bowel above it. In addition, the loop of bowel itself can die and cause a life-threatening infection throughout the body, called blood poisoning or septicaemia.

Less often there is a thickening of the ileum and other parts of the bowel caused by an inflammatory bowel disease (IBD) such as Crohn’s disease. Sometimes food or a gallstone blocks the bowel. A sharp piece of food, such as a fish bone, can pierce the bowel wall.

Rarely, the bowel is damaged by a blockage of its blood supply, called bowel ischaemia. Another rare cause is a tumor, which may be non-malignant (benign) or malignant (harmful).

It is also possible that the bowel may be damaged due to a previous operation. Some instruments used in keyhole surgery or to drain fluid from the tummy cavity could have been the cause.