A bowel resection is a surgery to remove any part of the bowel. This includes the small intestine, large intestine, or rectum. It’s also called a partial colectomy. Doctors use it to treat diseases and blockages of the large intestine.
Bowel diseases and conditions can put your life at risk. They can also keep the colon or rectum from working as they should. This causes symptoms like pain and discomfort.
Your doctor may recommend a bowel resection for one of the following reasons:
- Cancer: The amount of bowel he removes depends on the size and location of the cancer. Usually, it’s about one-fourth to one-third of the colon. The surgeon will take out nearby lymph nodes, too.
- Crohn’s disease: If medicine can’t keep this disease under control, removing part of your colon may provide relief. A bowel resection isn’t a cure for Crohn’s disease, though. Twenty percent of patients have a recurrence after 2 years.
- Diverticulitis: You may need surgery for complications, such as severe inflammation or infection.
- Blockage: When your intestine becomes blocked, food and liquid can’t pass. This can cut off the blood supply, causing tissue to die.
- Severe bleeding: If doctors can’t stop a bowel bleed, they may need to remove that section of the intestine.
Bowel Resection Surgeries
Colon surgery is done in one of three ways:
Open resection: A surgeon makes one long cut on the belly. He’ll use normal surgical tools to take out a portion of the intestine.
Laparoscopic resection: The surgeon makes two to four small cuts (incisions) on the belly. He inserts a thin tube with a tiny camera into one incision. This is called a laparoscope. It sends a picture to a monitor. The surgeon uses it to see inside the abdomen. He then passes small, special surgical tools through the other incisions to remove part of the intestine.
Robot-assisted laparoscopic resection: In this surgery, the instruments are attached to robots. The surgeon controls the robots to perform the surgery.
The type of surgery you’ll get depends on your condition. The location and size of the diseased or damaged colon are also factors. In some cases, your surgeon may need to change from a laparoscopic to open surgery during the procedure.
What Happens During a Bowel Resection?
This is a major surgery. You’ll need to check into a hospital. On the day of your surgery, you’ll get general anesthesia. That means you’ll go into an unconscious, sleep-like state so you don’t feel anything during surgery.
During the procedure, a surgeon will detach the large intestine from the surrounding organs and tissue. He’ll cut and remove the damaged or diseased part of the bowel. He’ll reconnect the healthy ends of the intestine with tiny staples or sutures.
In a small number of bowel resections, the surgeon will need to do a colostomy. This creates an opening in the skin, or stoma, for feces to pass into a bag. Your surgeon will perform a colostomy if there’s an issue that may keep the two ends of the intestine from healing properly. Most stomas are temporary. After 6 to 12 weeks, you’ll need a second surgery.
Preparing for Surgery
Before the surgery, you’ll go into your surgeon’s office. You’ll discuss your medical history and review what medications you’re on. You’ll also get tests, such as a chest X-ray, electrocardiogram, and blood tests. This helps your surgeon plan the procedure. It also spots any issues that might affect the surgery.
In the days before your surgery, your doctor may tell you to stop taking certain supplements and medicines, like ibuprofen. He’ll also tell you how to prepare for the procedure. To clear the bowels, you’ll need to avoid solid foods the day before surgery. Clear liquids, such as broth and apple juice, are fine. You’ll also take a laxative.
The night before and morning of your bowel resection, you’ll shower with an antiseptic wash. This can help prevent infections.
As with all surgeries, bowel resections come with certain risks or possible complications. They include:
Leakage: If the resection doesn’t heal properly or becomes infected, the colon can leak. Doctors call this an anastomotic leak. It can lead to bleeding and a dangerous infection. Call your doctor immediately if you have any symptoms, such as stomach pain, fever, or a rapid heart rate.
Hernia: This can develop as a result of the surgeon cutting your abdominal wall.
Scar tissue: As your intestine heals, scar tissue may form. Over time, this may cause a blockage.
After the surgery, you’ll stay in the hospital for about 2 to 4 days. Medication will help ease the pain. Your nurse or doctor will explain how to care for your wound. If you have a stoma, they’ll show you how to care for it.
Right after the surgery, you’ll be able to drink fluids. You may be able to eat solid foods the following day. Your surgeon might recommend eating a low-fiber diet for about a month.
Recovery from a laparoscopic surgery is faster than with an open resection. You’ll also have less pain and smaller scars.
After 1 to 2 weeks, you may be able to get back to most of your normal routine, such as walking and working. Don’t try to lift anything over 10 pounds or do intense exercise until you get your doctor’s OK. It usually takes around 6 weeks to recover fully.