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Bowel surgery

Bowel surgery is also called colon or intestinal surgery - we will be using the term bowel surgery in this book, although they all mean the same thing.

The following information has been prepared as a guide only, for your stay in hospital. Please remember, everyone is different and your care may be different in some ways. You will be guided by the surgical and nursing team as to what will happen for you. You may be surprised how quickly you can eat, drink and be out of bed after surgery. Recovery after surgery is a team effort - you, your family/ whānau and the staff caring for you working together.

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The bowel

The bowel is the large intestine; it is the lower partBowel-Diagram of your digestive tract. The intestine is a long, tubular organ consisting of the small intestine, the bowel (colon, large intestine) and the rectum, which is the last part of the bowel. After food is swallowed, it begins to be digested in the stomach and then empties into the small intestine. This is where the nutritional part of the food is absorbed. The remaining waste moves through the bowel to the rectum and is expelled from the body. The bowel and rectum absorb water and hold the waste until you are ready to expel it.

Patients undergo bowel surgery for a number of conditions including: polyps, inflammatory bowel disease
(Chrohn's and ulcerative colitis), diverticulitis and strictures.

This book covers bowel surgery that is NOT related to cancer.

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Types of Surgery

The area shaded dark blue is removed by the Surgeon


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Modern bowel surgery

Modern bowel surgery in the modern era differs in many ways from bowel surgery in the past. If you or your family/whānau have had surgery in the past, you will notice that current care will be different.

For example, new surgical and anaesthetic techniques have been developed to reduce the stress of surgery, to improve pain relief and to support your recovery. Oral bowel preparation (cleansing) is often not used. You will normally be allowed to eat and drink soon after surgery. You will move out of bed early after surgery. These and other measures allow you to go home within days, and more rapidly return to your usual activities.

This book will cover procedures that require an incision in the abdomen as well those performed with keyhole or laparoscopic surgery. For some patients undergoing bowel surgery a colostomy or ileostomy might be required. This may be temporary or permanent. Colostomies and Ileostomies will be explained in a special section in this book. Whether your surgery is planned or an emergency surgery, the information provided will be of value to you.

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What is Laparoscopic bowel surgery?

Laparoscopic or keyhole surgery involves several very small incisions rather than open surgery, which uses one large incision. Harmless carbon dioxide gas is introduced into the abdomen, inflating it, and creating a space for the surgeon to work. The surgeon introduces a long narrow camera and surgical instruments, and uses these to perform the procedure.

This surgery has some advantages, including less pain, a shorter hospital stay, and a quicker recovery. It also offers a reduced risk of wound infection or hernias. If for some reason your surgeon can not complete the procedure laparoscopically, he/she can convert to the open procedure safely. This would only be done in your best interests.

The surgery generally takes several hours and then you will spend some more time in the recovery room as you gently wake up from the anaesthetic. Some patients can expect to spend a day or two in the High Dependancy Unit after surgery.

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What complications (risks) can occur?

This section is not meant to frighten you, but help you to make an informed decision on whether to proceed with surgery. No surgery is risk free, but understanding the possible complications can help you make a better decision.

Most problems that can occur after this surgery are relatively minor and do not have a long-term effect on your recovery. Some complications may be more significant and require a longer hospital stay and recovery period.

Antibiotics at the time of surgery, deep breathing exercises and early mobilisation after surgery are some of the measures taken  to reduce the risks of these complications. Care is taken during surgery and your hospital stay to minimise risks, but there remains a chance that you could develop a complication which in rare cases, can cause death.

During Surgery

There are risks with any abdominal surgery where the use of surgical instruments may cause an accidental injury.  In this case it may be to the bowel or other closely related organs such as the pancreas, spleen or the liver.

After surgery

  • Infection: Possible sites include chest infection (pneumonia); urinary tract infection; wound infection, or deep with the abdomen. Severe infection can lead to a prolonged hospital stay and further surgery.
  • Bleeding: This may require transfusion or return to the operating theatre. (there is more information on blood transfusion on page 16)
  • Allergic reactions: To medication; anaesthetic agents.
  • Delay to normal gut function: Due to the gut being handled during surgery.
  • Nerve or muscle injury: Due to positioning during surgery, or related to intravenous and arterial lines.
  • Blood clots: Can occur in the lower leg (deep vein thrombosis, or DVT) or in the lungs (pulmonary embolus).

    There is a small risk of developing DVT following surgery. When detected, the treatment may involve blood thinning injections, followed by a course of tablets. You will be given medications and compression stockings to reduce this risk
  • Leak: A leak can occur where the two end of bowel are joined.
  • Stroke.
  • Heart attack or abnormal heart rhythm.
  • Respiratory failure: The inability to breathe adequately after surgery. This may require support of breathing in an intensive care unit.

All surgeries, whether planned or urgent, carry a risk of death.

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Last updated: August 29, 2018