The operation is performed under a general anaesthetic and usually takes 2 to 3 hours. Your surgeon will remove part of your colon. Your surgeon will usually join the ends of your bowel back together inside your abdomen. For safety reasons, they may make a stoma (your bowel opening onto your skin).
The right surgical technique depends on the location of the diverticulitis in the colon, the individual's overall health, and a surgeon's comfort and experience. This is minimally invasive, and typically requires 3 to 5 small cuts in the abdomen, while traditional surgery involves one large incision.
It's normal to experience some pain, nausea, and drowsiness as the anesthesia wears off. Your nurse can give you medication to help control your symptoms. Once you are fully awake and your pain is under control, usually within a few hours, you will be wheeled on your bed to a hospital room.
The surgery involves removing the sigmoid colon as well as a small area of the rectum. Because diverticula can also occur in other parts of the intestine, it's usually not possible to remove all of them. After the affected section of intestine has been removed, the ends are sewn back together again.
You should be up and walking within a day or two after surgery. This will encourage your circulation and bowel function to return to normal, and may prevent complications. Do your breathing exercises to make sure you are inflating your lungs completely.
Bowel Resection with Primary Anastomosis
After the affected areas are removed, the healthy parts of your colon are sewn together from either side of the previously infected area (anastomosis). This will allow you to retain function of your colon and will not result in an ostomy bag.
You may need to wear a colostomy bag to catch the poop when it comes out. Some people only have a colostomy for a few months, and others need it for life. A colostomy often follows a colectomy, a procedure to remove part or all of your colon.
After you go home, you may have diarrhea on and off during the first month. It takes about three months for the bowels to learn their “new normal.” You'll need to avoid heavy lifting for six to eight weeks to prevent a hernia.
Most people with diverticulitis recover completely. But, at its most severe, a pouch can burst open, spilling fecal matter directly into a person's bloodstream. This results in an immediate risk of developing a blood infection called sepsis, which can be life-threatening.
Most of the time, diverticulitis does not require surgery. If mild, the condition can sometimes be treated with medication and dietary changes.
For most people, diverticulitis won't affect their life span. Many people don't even know they have diverticular disease. Only a small percentage will have symptoms, and an even smaller number will have complications.
According to the American Gastrointestinal Association (AGA) guidelines, it is recommended to perform a colonoscopy six to eight weeks after resolution of acute diverticulitis [1].
Your NYU Langone gastroenterologist may recommend surgery if symptoms of diverticulitis haven't improved after nonsurgical treatment; if a perforation or fistula, a connection that forms between the intestines and another organ, develops in the colon wall; or if a diverticular pouch ruptures.
Surgery for diverticular disease can be performed by laparoscopic or minimally invasive techniques. Surgery involves removing part of the colon, usually the sigmoid colon, and reattaching it to the rectum.
STAGES OF DIVERTICULITIS
This abscess may be walled off by colon, mesocolon, omentum, small bowel, uterus, fallopian tubes and ovaries, and/or pelvic peritoneum. Stage III: General peritonitis resulting from the rupture of either a pericolic or pelvic abscess into the free peritoneal cavity.
“Generally speaking, inflammation from diverticulitis can cause scar tissue formation and breakdown of the colon wall, and if the colon wall develops a hole, then an abscess will form,” warns Will Bulsiewicz, MD, a gastroenterologist and gut health expert in Mount Pleasant, South Carolina.
About 15%-25% of patients who present with a first episode of acute diverticulitis have disease severe enough to require surgery. Up to 22% of those who have surgery will have a future attack.
Drink extra fluids, 6 to 8 cups of fluid per day is recommended. Foods low in fibre are usually digested better at first. It is normal to lose some weight after this surgery.
The individual surgical complication rates were: intra-abdominal abscess, 3.59% with 95% CI 2.69–4.78, p < 0.001; anastomotic leak, 3.99% with 95% CI 3.07–5.18, p < 0.001; bleeding, 2.13% with 95% CI 1.5–3.02, p < 0.001; wound infection, 6.78% with 95% CI 4.17–10.85, p < 0.001; and wound dehiscence, 2.16% with 95% CI ...
You are likely to have pain that comes and goes for the next few days after bowel surgery. You may have bowel cramps, and your cut (incision) may hurt. You may also feel like you have influenza (flu). You may have a low fever and feel tired and nauseated.
How quickly you get better depends, in part, on whether you had a laparoscopic or open surgery. But you will probably need at least 6 weeks to get back to your normal routine. This care sheet gives you a general idea about how long it will take for you to recover.
In general, people with an ostomy can eat and drink what they want unless the surgeon or ostomy therapist has given counter-advice. But as before the surgery some food may be easier to digest than others – and right after surgery it may be helpful to pay some extra attention to the signals from your body.
Irrigation is an alternative to wearing a colostomy appliance. It involves washing out your colon with water either every day or every other day.