Small Bowel Resection Overview

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 a laparoscopic technique.

Small Intestine © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Blood and urine tests
• X-rays of the chest and abdomen
• CT scan of the abdomen

Leading up to your procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• Take medicines as recommended by your doctor. This may include antibiotics.
• Your intestines should be cleaned out for the surgery. During the week before surgery, eat high-fiber foods and drink 6-8 glasses of water per day. This will encourage bowel movements. Other cleansing methods may also be recommended, including enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution that helps with the complete emptying of your intestines.
• Begin fasting as directed by your doctor.

Anesthesia

General anesthesia will be given. You will be asleep.

Description of Procedure

The procedure may be done with one of two methods:

• Traditional open incision—An incision will be made into the abdomen in the area of the diseased intestine.
• Laparoscopic technique—A few small incisions will be made in the abdomen. Carbon dioxide gas will be pumped into the abdomen through an incision. A laparoscope (thin tube with a small camera on the end) and special tools will be inserted through the incisions. The laparoscope sends a view of the interior of the abdomen to a video monitor.

In either type of surgery, the small intestine will be 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 may be joined together. Otherwise, a permanent or temporary ileostomy is created. An ileostomy is an opening (called a stoma) in the abdomen. The end of the small intestine closest to the stomach is attached to the opening. This allows intestinal contents to drain into a sealed pouch on the outside of the body. If a temporary ileostomy is created, another operation will be necessary several months later to reverse it.

Pouch Created During Ileostomy © 2009 Nucleus Medical Media, Inc.

The abdomen incisions will be closed with stitches.

How Long Will It Take?

About 1-4 hours

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. Talk to your doctor about medicine to help manage the pain in recovery.

Average Hospital Stay

The usual length of stay is 5-7 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

A catheter will be placed in your bladder before surgery. You will also have a nasogastric tube. This is a small tube that goes in through your nose and down into your stomach. The tube may be used to drain fluids from your stomach or to help deliver food to your stomach. The catheter and tube will remain until you are able to eat and go to the bathroom normally.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Your doctor will tell you when you can resume your normal activities.

• Check with you doctor about doing any heavy lifting or tiring activities.

• Do not drive unless your doctor has given you permission to do so.

• Do not take showers or go in tub baths, hot tubs, or swimming pools until your doctor say it is ok.

• Exercise your legs while in bed to prevent blood clots.

• If you go home with an ileostomy, you will receive instructions on how to change the bag and maintain personal hygiene.

• Be sure to follow your doctor's instructions .

RESOURCES:

American College of Surgeons
http://www.facs.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCES:

The Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org/default.aspx

Canadian Cancer Society
http://www.cancer.ca/

References:

Mayo Clinic website. Available at: http://www.mayo.edu/ .

National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ .