A small bowel resection is the removal of part of the small intestine. The small intestine includes the duodenum, jejunum, and ileum. The surgery can be done through an open incision or using smaller incisions using a tool called a laparoscope.
Reasons for Bowel Resection
This procedure may be done to treat the following conditions:
- Intestinal blockage
- Bleeding, infection, ulcers, or holes in the small intestines
- Cancer
- Precancerous polyps
- Crohn's disease
- Injury
Potential Complications
Problems from a bowel resection procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Excessive bleeding
- Infection
- Blockage of the intestine caused by scar tissue
- Hernia formation at the incision site
- Leakage from joining of intestinal edges
- Inability to get enough nutrients and vitamins if too much intestine needed to be removed
Factors that may increase the risk of complications include:
- Smoking
- Previous abdominal surgery
- Malnutrition
- Chronic illness
- Drug use
What to Expect from the Procedure
Prior to Surgery
Before the procedure, your doctor may do the following:
- Physical exam
- Blood and urine tests
- Chest and abdominal x-rays
- Abdominal CT scan
During the Procedure
You will be given general anesthesia prior to surgery so that you will be asleep and not feel any pain during the procedure. Bowel resection surgery may be done with one of two methods:
- Traditional Open incision
A 6 to 8 inch incision is made in the abdomen in the area of the diseased intestine. The diseased portion of the colon is then removed.
- Laparoscopic Technique
Laparoscopic bowel resection is considered less invasive than traditional open surgery. A few small incisions are made in the abdomen and harmless carbon dioxide gas is pumped into the abdomen through an incision in order to make the intestines more visible to the surgeon. A laparoscope, which is a thin tube with a small camera on the end, is then inserted through the incisions. The laparoscope sends a view of the interior of the abdomen to a video monitor. A doctor then guides small robotic arms through the small incisions, which allows for greater range of movement than a doctor's hand.
In either type of surgery, the small intestine is clamped above and below the diseased section. This section will be cut free and removed. If there is enough healthy intestine left, the free ends of the intestine are joined together.
After surgery, abdomen incisions are closed with stitches. Bowel resection surgery usually takes between 1 and 4 hours.
Post-procedure Care
The usual length of stay is 5 to 7 days in the hospital. Your doctor may choose to keep you longer if complications arise or if you had a large amount of intestine removed. A catheter will be placed in your bladder before surgery and you also will have a nasogastric tube. This is a small tube that goes in through your nose and down into your stomach. The tube is used to drain fluids from your stomach or to help deliver food to your stomach. The catheter and tube will remain in place until you are able to eat and go to the bathroom normally.
Any discomfort you feel can be managed with pain medication.
At Home
Once home you will have some activity restrictions, such as avoiding heavy lifting. Moving around will help prevent blood clots and promote healing. Follow wound care instructions to avoid infection. Your healthcare team will teach you how to care for your ileostomy and provide you with additional support resources.
Most people who have bowel resection surgery will recover completely and be able to resume most activities that they did prior to surgery. Those with chronic conditions, like Crohn’s disease or cancer may require ongoing treatment.
When to Contact Your Doctor
Contact your doctor if your recovery is not progressing as expected or if you develop complications, including:
- Signs of infection, such as fever and chills
- Any redness, swelling, bleeding, or drainage from the incision site
- Your bandage becomes soaked with blood
- Stitches or staples come apart
- Persistent nausea and/or vomiting
- Persistent abdominal pain or bloating
- Constipation or diarrhea
- Rectal bleeding or tarry-colored stools
- Pain that you cannot control with the medications you were given
- Cough, shortness of breath, or chest pain
- Pain, burning, urgency, frequency of urination, or persistent blood in the urine
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away. For questions or concerns about bowel issues, Dr. Amanda Reese is welcoming new patients. To schedule an appointment, please call the office at (540) 552-0005.