During colon resection surgery (bowel resection) the diseased part of the large intestine is removed and the two healthy ends are sewn back together (resectioned). This surgery is used to treat many conditions, such as bowel obstruction, diverticulitis, Crohn’s Disease and colon cancer. A bowel resection may be performed as a traditional “open” procedure or as a minimally invasive laparoscopic procedure. The surgery is performed in a hospital setting under general anesthesia and can involve a hospital stay of up to 7 days
What is Colon Resection?
Colon resection is surgery to remove part of the large bowel. The large bowel, also called the large intestine or colon connects the small intestine to the anus and is part of the digestive tract. During colon resection, the diseased or damaged section of the intestine is removed and the two healthy sections of the colon are reattached. Colon resection can be performed through two different techniques:
Open surgery – This procedure involves making an incision in the abdomen and removing the diseased section of the colon. The healthy ends of the colon are stapled or sewn back together.
Laparoscopic surgery – In this procedure, small incisions are made in the abdomen, and a laparoscope is inserted. The laparoscope has a tiny camera on the end to allow the surgeon to see the intestine. Other instruments are inserted into the incisions to remove the section of the colon. Laparoscopy is a minimally invasive technique.
Who are candidates for Colon Resection?
Large bowel resection is used to treat a variety of conditions, including:
Diverticular disease – when small sacs or pouches that develop in the colon become chronically infected and inflamed.
Intestinal blockage caused by scar tissue
Bowel resection may also be performed for these conditions:
Ulcerative colitis – a form of inflammatory bowel disease that causes swelling and ulcerations.
Precancerous polyps – swollen thick membranes that grow on the lining of the colon that may eventually cause cancer.
Familial polyposis – an inherited condition in which polyps (swollen thick membranes) develop on the lining of the colon.
Depending on the type of resection, a colostomy may be required. A colostomy is a surgical opening made through the abdomen to allow a path for elimination of waste. It may be a temporary or permanent condition to allow the colon to heal. A colostomy may be required under these circumstances:
Intra-abdominal infection, such as perforated diverticulitis
Injury to the colon or rectum (for example, a gunshot wound)
Perineal wounds or fistulas – abnormal connections between that occur between parts of the intestine
How do you prepare for Colon Resection?
Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.
It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.
Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.
Depending on the circumstances of your surgery, you may be instructed to do the following:
Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.
What is the Colon Resection recovery process?
The length of your hospital stay will depend on the type of procedure. Open surgical technique result in longer recovery compared to laparoscopic techniques. For open surgery, you can expect the following:
You will have sutures (stitches) or metal clips (staples) to hold your incision together with gauze bandages covering the incision. Stitches under the skin dissolve, but in almost all cases you will have to have some sutures or staples removed about seven to ten days after surgery.
You may need assistance standing up, but you will be encouraged to walk around your room and to the bathroom.
You should expect to stay in the hospital two to seven days following the procedure at which time, the medical staff will evaluate your pain levels, fluid intake, increase walking/sitting times and getting nutrition by mouth.
Your activity should be limited for several weeks. Your body will need almost two months to return to a normal activity level. Walking and other gentle activities are very important to regaining your strength. Avoid any strenuous physician activity such as heavy housework such as vacuuming, until approved by your physician. Do not lift anything heavier than 10 pounds for at least six weeks after surgery. Walk a little more each day.
For laparoscopic surgery, you can expect the following:
You will be encouraged to walk the day after surgery
You will likely return to normal activities in two weeks
For either procedure, follow the diet recommended by your doctor, drink plenty of fluids and do not take laxatives unless approved by your doctor.