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Laparoscopic Bowel Resection
WHAT YOU NEED TO KNOW:
Laparoscopic bowel resection is surgery to remove all or parts of the small or large intestine (bowel). This is done to treat conditions such as intestinal bleeding, blockages, inflammation, or infections. It may also be done to remove large polyps (growths) or early signs of tumors in the intestines. Your healthcare provider will make small incisions in your abdomen and use a long, thin scope to do the surgery. The amount of intestine removed depends on the reason why this surgery is needed. An ileostomy or colostomy, which is an opening in the abdomen to drain bowel movement into a bag, may also be made.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent 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.
- Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty your bowel.
- An IV is a small tube placed in your vein that is used to give you medicine or liquids.
- Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
- 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.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
- Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.
- Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
- 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.
During your surgery:
- Your abdomen and genital area is cleaned with soap and water. Sheets are put over you to keep the surgery area clean.
- During your surgery, a small incision is made near your belly button to insert the laparoscope through. Your healthcare provider inserts other instruments by making 2 to 5 smaller incisions on your abdomen. The abdomen is then filled with a gas (carbon dioxide) to lift the abdominal wall away from the internal organs. This gives healthcare providers more space to work. Tools are used to separate the affected bowel from the healthy part. Certain blood vessels are tied and cut. Part or all of the small or large bowel is removed. The remaining healthy parts of the bowel are attached or sewn together.
- Your healthcare provider may send samples of bowel tissue to the lab for tests. Lymph nodes may also be removed during surgery. Thin rubber tubes may be put into your skin to drain fluid or pus from the abdomen. A colostomy or ileostomy may be made. The incisions are closed by stitches or surgical tape and covered with bandages.
After your surgery:
You may be taken to a recovery room until you are fully awake. Healthcare providers will watch you closely for any problems. When healthcare providers 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 healthcare provider may remove the bandages soon after your surgery to check your wound, tubes, drains, or ostomy.
- 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.
- 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 healthcare provider before you take off the mask or oxygen tubing.
- Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
- You may need to wear inflatable boots after surgery. The boots have an air pump that tightens and loosens different areas of the boots. This device improves blood flow and helps prevent clots.
- A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.
- Post-operative ileus: Post-operative ileus is when the bowel does not start working as expected after surgery. This may cause nausea, vomiting, and you may have no gas or bowel movements. You may also have abdominal pain and feel bloated. This condition may last for a few days. Your healthcare provider may ask you to get out of bed and start walking to get your bowels moving. He may also give you medicines and start you on a liquid diet, or you may need an NG tube.
- 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.
- Diet: You may be able to eat when bowel sounds (stomach growlings) are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. If you have a colostomy or ileostomy 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.
- Medicines: You may need any of the following:
- Pain medicine: You may need medicine to relieve or decrease your abdominal pain. Tell your healthcare provider if the pain medicine does not help or if you have any questions about your medicine.
- Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
- Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.
- Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
- Preventing blood clots: Around the time of your surgery or procedure you may need to take medicine to thin your blood. Blood thinning medicine helps prevent blood clots from forming in your veins. This medicine makes it easier for a person to bruise and bleed. You will need regular blood tests while taking this medicine. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use. Physical activity helps prevent blood clots. Caregivers will help you be as active as possible after your surgery or procedure.
- 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 healthcare provider'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 or brain. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
- Without this surgery, your signs and symptoms may continue and become worse. Your intestines may get blocked or the infection may spread to other parts of the body. This may lead to serious medical problems, such as peritonitis (infection of abdominal wall membrane) and sepsis (blood infection). If a polyp or tumor is not removed, it can cause further blockage. Ask your healthcare provider if you are worried or have questions about your surgery, medicine, or care.
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.
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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.