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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 caregiver 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.
HOW TO PREPARE:
The week before your surgery:
- Ask a family member or friend to drive you home after your hospital stay. Do not drive yourself home.
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
- Tell your caregiver if you have other diseases, including bleeding disorders, or heart or kidney problems. Tell your caregiver if you have had other surgeries in the past.
- If you are female, tell your caregiver if you know or think you might be pregnant.
- You may need to have abdominal x-rays, a computed tomography (CT) scan, ultrasound, or colonoscopy. Other tests may also be needed, such as chest x-ray, electrocardiogram (ECG), or blood or urine tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
- You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
- Directions for eating and drinking:
- A clear liquid diet or a diet that helps to clean out your bowel may be started 1 to 4 days before your surgery. Clear liquids may include plain gelatin, unsweetened fruit juices, clear soup, or broth.
- Do not eat foods with residue or fiber that are hard to digest. These include fruits, vegetables, cereal, nuts, peas, beans, fried foods, and bread.
- Increase the amount of water you are drinking. Make sure you drink 8 to 10 (eight-ounce) cups of liquid, especially on the day before your surgery.
The day before your surgery:
Bowel preparation: Your bowel may need to be prepared and emptied before your surgery. Your caregiver may tell you to take a laxative. These medicines may give you diarrhea, but will quickly clean out your bowel.
The night before your surgery:
- Ask caregivers about directions for eating and drinking.
- Bowel preparation: You will need to clean out your bowel to get ready for this surgery. Your caregiver may ask you to do one or more of the following:
- You may need medicine called an enema. An enema uses warm water that is put into your rectum to help empty your bowel. Ask your caregiver how to do this, and follow the directions on the package.
- You may be given 8 to 12 (eight-ounce) cups of special bowel prep medicine to drink. Drink 1 eight-ounce cup of bowel prep medicine every 10 minutes until you are passing clear fluid. Ask your caregiver for more information about this medicine.
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- What to bring: You may want to bring items such as a toothbrush and bathrobe.
- Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
- Bowel preparation:
- Do not eat or drink anything on the morning of your surgery. Your bowel needs to be totally empty during your surgery. If you need to take medicines, you may have them the morning of your surgery with few small sips of water.
- You may need an additional enema, using warm water, the morning of your surgery.
- You may also be asked to drink 4 to 8 (eight-ounce) cups of special bowel prep medicine. This may need to be done if you drank the bowel prep medicine the night before.
- If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
- Do not wear tight-fitting clothes on the day of your procedure or surgery.
- Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine. Your caregiver may give you an antibiotic medicine 30 minutes before your surgery to help prevent infections.
- An anesthesiologist may talk to you. This caregiver will give you medicine to make you sleepy before and during your surgery.
- You or a close family member will be asked to sign a consent form. It gives your caregiver permission to do the surgery. It also explains the problems that may happen and your choices. Be sure all your questions have been answered before you sign this form.
WHAT WILL HAPPEN:
What will happen:
- You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room and then moved onto a special bed. Your abdomen will be cleaned. You will receive anesthesia to keep you comfortable or asleep during surgery. An endotracheal (ET) tube connected to a breathing machine may be put into your mouth. This will help you breathe during your surgery. A catheter may be inserted to drain your urine. A nasogastric (NG) tube may also be inserted to keep air and fluid out of your stomach during surgery.
- During surgery, a small incision will be made near your belly button to insert the laparoscope through. Caregivers will insert other instruments through 2 to 5 smaller incisions on your abdomen. The abdomen will then be filled with a gas (carbon dioxide) to lift the abdominal wall away from the internal organs. The affected bowel will be separated from the healthy part. Blood vessels will be tied and cut. Your caregiver will then remove all or part of the small or large bowel. The remaining healthy parts of the bowel will then be attached or sewn together.
- Your caregiver may send samples of bowel tissues to the lab for tests. Lymph nodes may also be removed during surgery. Thin rubber tubes may be placed to drain fluid or pus from the abdomen. A colostomy or ileostomy may be made. The incisions will be 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. The ET tube may be removed after you are awake and can breathe well on your own. The NG tube going into your stomach may remain for a while. 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, tubes, drains, or colostomy or ileostomy.
CONTACT YOUR HEALTHCARE PROVIDER IF:
- You cannot make it to your appointment on time.
- You have a fever.
- You have constipation and the medicines are not helping to empty your bowel.
- You have questions or concerns about your surgery.
Seek Care Immediately if
- You are not able to eat or drink, or are urinating less or not at all.
- You have blood in your bowel movement.
- You are unable to have a bowel movement.
- Your abdomen becomes tender and hard.
- 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 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 caregiver if you are worried or have questions about your surgery, medicine, or care.
Care AgreementYou 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.