For bowel surgery, surgeons cut either one long incision down the middle of the abdomen (open surgery) or several small cuts (keyhole/laparoscopic surgery) to access and remove the diseased section of the intestine, joining the healthy ends or creating a temporary or permanent stoma if needed. The location and size of the cuts depend on the surgical approach (open vs. keyhole) and the specific part of the bowel being operated on.
The surgeon can use an open technique or a laparoscopic technique. With the open technique, a large cut (incision) is made in the abdomen to reach the intestine.
Any bowel resection is major surgery and comes with certain risks and complications. They include: Bleeding inside the belly. Blood clots in the legs or lungs.
During a colectomy, an anesthesiologist administers drugs to help the patient fall asleep, stay asleep and feel no pain (called general anesthesia). The surgery itself may take up to four hours, and the patient may be in the hospital recuperating for two to seven days.
If you have open surgery: Your surgeon makes a cut of 6 to 8 in (15.2 to 20.3 cm) in your lower belly. The organs in your belly are examined to see if there are any problems. The diseased part of your large bowel is located and removed.
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 the flu. You may feel tired and nauseated.
Overview. Your recovery time after the operation will depend on your age, whether you had open or keyhole surgery, whether you have a stoma, and your general health. You will probably be in hospital for 2–7 days, but it can take 2–3 months to fully recover.
Start by going for short walks every day, gradually increasing the distance you walk. Most patients are able to get back to normal (including participating in sport or exercise) approximately 6–8 weeks after they go home. You should not go swimming until your wound is completely healed.
Drink 2-3 quarts of water and clear Gatorade or diet soda during the afternoon. Do not eat or drink anything for 8 hours before surgery. In some cases, antibiotics by mouth should be taken. Neomycin and metronidazole (Flagyl) tablets should be taken at 5:00 PM, 6:00 PM and 10:00 PM.
A patient stays in the hospital for 3 to 7 days with the average of 4 days. You will begin to have bowel movements 2 to 5 days after this operation. Initially the movements are liquid and may occur 10 or more times a day.
Risks of bowel surgery
These may include infection, bleeding, blood clots, damage to nearby organs, or leaking from the joins between the remaining parts of the bowel. After the operation, you will be carefully monitored for any complications.
Opening your bowels
Your bowel function may change after part of your bowel has been removed. It is quite normal for it to take several days for your bowel to open after surgery. You will begin by passing wind and then you will get the normal sensation of needing to open your bowels.
The stoma may be temporary or permanent. If you have a temporary stoma you may have another operation a few months later to join the ends of the bowel back together. This is called a stoma reversal. In the meantime you wear a colostomy or ileostomy bag over the opening of the bowel, to collect your poo.
After proctocolectomy to remove your colon and your rectum, your surgeon may connect your small intestine to your anus (ileoanal anastomosis). This allows you to expel waste normally, though you'll likely have several watery bowel movements daily.
If your GI tract is perforated, the contents can spill into your abdomen and cause peritonitis, an infection. Such an infection can lead to sepsis. Sepsis is a life-threatening emergency that happens when your body's response to an infection damages vital organs and, often, causes death.
Sometimes, part or your large bowel may also need to be removed. There are 2 main ways colostomy surgery can be done: laparoscopic (keyhole) surgery, where a few small cuts (incisions) are made in your tummy. open surgery, where a single larger cut is made in your tummy.
Some conditions like rectal and colon cancer, Crohn's disease and ulcerative colitis may require colorectal surgery.
You will be given general anesthesia before the colectomy so you stay asleep and pain-free during surgery. A colectomy may be performed laparoscopically or with open surgery, depending on which surgery you will have. The entire procedure may take up to four hours.
You may not have a bowel movement for four to five days following surgery.
Your stay in hospital will be shorter (3–5 days) than if you had an open operation (10–12 days) You will be able to resume your usual activities in 2–3 weeks and your usual diet the day after laparoscopic colorectal surgery—patients who have an open operation usually take a little longer to get back to normal.
Most patients will not need a stoma or will only need a temporary one to allow the intestines to heal. Depending on the severity of the disease and the surgery, a permanent stoma may be necessary.
Complications of bowel surgery include the following. The new join in your bowel may leak (an anastomotic leak). This can cause severe tummy (abdominal) pain, and you may feel very unwell with a high temperature. You may need to go into hospital for further treatment and surgery.
If you need advice please contact your specialist nurse or GP. If you have had laparoscopic surgery you should be able to start driving after 2-3 weeks. If you have had an open operation, you will need to wait around 6 weeks to commence driving.
Generally, the diseased part of the bowel is removed together with some healthy tissue on either side. The healthy ends are either joined together or one end is attached to a stoma (and the other end is stitched closed).