Laparoscopic Colostomy Reversal

WHAT YOU SHOULD KNOW:

• Laparoscopic (lap-ah-ROS-ko-pik) colostomy (ko-LOS-to-me) reversal is surgery to reconnect your colon (large intestine) with your rectum after a previous colostomy. A colostomy is an opening in the abdomen (stomach) to drain stool (bowel movements) into a bag. A laparoscopic colostomy reversal restores the appearance and function of your abdomen, intestines, and rectum. The intestines are part of the gastrointestinal (GI) system where food is digested (broken down). The small intestine is the tube that runs from the stomach to the colon. It is made up of the duodenum, jejunum, and ileum. The colon is the long tube that connects the small bowel with the rectum. The colon absorbs water from digested foods and turns the digested food into stool. The rectum and anus are where the stool leaves your body.
  
  
• In a laparoscopic colostomy reversal, your caregiver makes small incisions (cuts) in the abdomen. He uses a laparoscope and other special tools to do the surgery. A laparoscope is a long metal tube with a light and tiny video camera on the end. This gives your caregiver a clear view of the abdominal area while watching the images on a screen. The ends of your rectum and large intestine are then connected, and the incisions are closed with stitches. With a laparoscopic colostomy reversal, you may be able to have bowel movements normally again. You may also be freed from the trouble of taking care of a colostomy, and return to your usual activities.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Not doing bowel preparation correctly can cause problems during surgery, or your surgery may need to be cancelled, delayed, or done again. Problems may happen during your laparoscopic surgery that may lead to an open surgery. Your stomach, liver, intestines, blood vessels, or nerves may get injured while having the surgery. This may cause too much bleeding and blood loss, or the bowel contents to leak. You could also have trouble breathing or an infection during or after surgery. The special gas used during your surgery may cause shoulder or chest pain for 1 to 2 days after your surgery. Following your caregiver's advice may decrease the possible problems.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• Without this surgery, you will continue living with the troubles of taking care of a colostomy. Your abdomen may not return to its usual appearance and your bowel movements will continue to go out through your colostomy. Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty its contents.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Nasogastric (NG) tube: A nasogastric (NG) tube may be inserted to keep air and fluid out of your stomach during surgery.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your surgery:

• Your abdomen (stomach) and genital area are cleaned. Sheets are put over you to keep the surgery area clean.
  
  
• During surgery, your colostomy is freed up from its attachment to the abdomen. Your caregivers will make an incision where the laparoscope is passed through. Your abdomen is then filled with a gas (carbon dioxide) to lift the abdominal wall away from the internal organs. This gives your caregiver more room to work in. Two to five smaller incisions are made where other special instruments may be inserted. Your bowel and rectum are cleaned up and unhealthy tissues are removed. The prepared ends of your colon and rectum are brought close together. A stapling device is inserted through your colostomy opening and anus to connect the ends from inside. The incisions are closed with stitches (threads) and covered with bandages.

After your surgery:

You may be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound.

• Activity:
  
  
  • Until you can get out of bed, start doing leg exercises. Do this by drawing circles with your toes. This will make your legs stronger and stop blood clots from forming.
    
    
  • It is important to get moving as soon as possible after surgery. Ask your caregiver when you can get up for the first time. Any time you feel weak or dizzy, lie down right away and call your caregiver.
  
  
• Diet after surgery: You may not be able to eat solid food for several days. Ice chips are usually given first. Liquids such as water, broth, apple juice, or lemon-lime soda pop may be allowed within a few days. You may also be given special drinks that are complete with nutrients you need everyday.
  
  
• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.
  
  
• Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Laparoscopic Colostomy Reversal (Inpatient Care)