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Bowel Resection

Bowel resection is a surgical procedure wherein part of the large or small intestine needs to be removed. The most common reasons for needing a bowel resection include:

  • Cancer
  • A ruptured diverticulum
  • An obstruction in the colon
  • Traumatic injury
  • Intestinal polyps
  • Ischemia (meaning, the blood supply is compromised)

During the surgery, the affected part of the intestine is removed and the remaining ends are re-connected in an end-to-end anastomosis.

Methods for Performing A Bowel Resection

Open Surgery

Bowel resection can be performed using one of two different methods. The first method is an open surgery wherein the patient is catheterized to monitor urine output as well as provide proper hydration. The patient receives general anesthesia and an incision is made in the abdomen. The affected part of the colon is located and the surgeon clamps off the portions of the bowel before and after the diseased part. Next, the surgeon removes the affected section and performs the anastomosis—the reconnection of the healthy ends of bowel. An open surgery for bowel resection can last up to 3 hours depending on the severity of the affected colon.

Anastomosis is performed with surgical staples or the bowel is sewn back together by hand. In some cases, the anastomosis cannot be performed due to injury or stress on the tissue. Sometimes, the colon must heal before an anastomosis is a viable option. Therefore, an ostomy may be performed as a backup method.

An ostomy occurs when the surgeon brings one end of the bowel outside the body (through the incision) and connects it to a tube used to dispose of waste until the anastomosis can be completed. The specific term used depends on the part of the intestine involved, with the large and small intestines respectively needing a colostomy or an illeostomy. In severe cases, such as for people suffering from colon cancer, it may be necessary for the colostomy to be permanently fixed. Approximately 15% of colon cancer patients have permanent colostomies.

Laparoscopic Surgery

The second type of bowel resection option is called Laparoscopic surgery. Laparoscopy is a modern way of performing surgery for many types of conditions that is quickly becoming the method of choice among surgeons.

For Laparoscopic surgery, up to 5 small incisions are made in the abdomen. A Laparoscope (a thin, telescopic instrument) is sent through one or more of the incisions to locate the affected area. The Laparoscope itself is a tiny camera giving the surgeon an interior view of the body. Once the bad section is found, small surgical tools are sent in through the other incisions, the affected part is removed, and an anastomosis is performed assuming of course the remaining ends are healthy enough.

With Laparoscopic surgery, a patient usually feels less pain, develops less noticeable scars, and must stay in the hospital for a much shorter time. Laparoscopy usually involves a mere two to three days compared to the traditional three to ten days needed after open surgery. Plus, the patient’s recovery time is substantially condensed.

Pre-Surgical Preparations

You can expect to receive a bank of tests before undergoing any surgical procedure. The exams may include an EKG, a chest X-Ray, an abdominal CT scan, or a colonoscopy. Blood work is also a given.

Since the surgery is usually more successful (and the chance of infection is reduced) when your colon is clean, you will probably be put on a cleansing diet beforehand. Your doctor will likely prescribe antibiotics to help ensure you do not develop an infection.

The day of the surgery is usually quite long because you must arrive at the hospital early if you did not check in the night before. You will have to drink a liquid laxative to ensure everything is out of you. An IV will be installed to prevent dehydration since you may not be permitted fluids and laxatives are known to dehydrate the body.

Effects of Resectioning Your Bowel

After surgery, it’s important to examine your incisions often. If you notice swelling, bleeding, drainage from the incision site, rectal bleeding, or a sudden fever, you should contact your doctor immediately. Potential risks involved with bowel resection surgery, while rare, can include pneumonia, infection, incisional hernia, thrombo-phlebitis, and pulmonary embolism.

You can expect to return to normal, non-strenuous activities about one to three weeks after surgery. Heavy lifting or other more strenuous activities should be avoided for a minimum of four to six weeks.

While bowel resection surgery is usually safe, it’s still important to consider all the potential risks and effects of anything that’s going to physically alter your internal structure. Being aware of all the pros and cons can greatly increase your chances of a having successful bowel resection surgery and get you back to your normal life as quickly as possible. Of course, it would be best to avoid such drastic measures, so take good care of your digestive system by eating organic foods, drinking plenty of purified water, engaging in regular exercise, sleeping well, and take care of any problems as soon as possible. Don’t wait until surgery is your only option before you decide to take action!

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