Small bowel resection

Overview

Small bowel resection, also known as small intestine resection, is necessary if you have a severe gastrointestinal condition or an injury. The damaged or diseased part of your small bowel (intestine) is removed during this treatment, which usually has no impact on how well your digestive system works. It is intended for those who have congenital malformations, hernias, advanced Crohn’s disease, and other conditions.

The length of your small bowel is 20 to 30 feet. It is made up of several layers of twisted and folded tissue. Your body gets nutrients from the food you ingest through this organ. Intestinal function is usually unaffected by the removal of a portion of tissue.

Types

Small bowel resection surgical procedure can be performed by:

• Laparoscopic surgery: Tiny incisions are made during laparoscopic surgery, and your surgeon inserts thin tubes with instruments and a camera at the tip through them.
• Robotic surgery: Surgeons can now safely perform surgeries in difficult-to-reach regions by using robotic surgery. Your surgeon’s hands are more precise and have a wider range of motion because of robotic technology.
• Open surgery: To reach your small bowel during open surgery, a single, large incision is made in the mid-abdomen. If you are not a candidate for a robotic or laparoscopic operation, then this method might be required.

Reason for undergoing the procedure

If conservative treatments fail to improve your GI wellness, you might require a resection. These include prescribed medications or a particular diet. When there is a life-threatening situation, such as an obstruction, rapid surgical intervention is required.

Patients with severe gastrointestinal (GI) disorders are candidates for this surgery. Among them are:

• Abnormal growths: Polyps, tumors, and small intestinal cancer.
• Congenital GI disorders: Congenital gastrointestinal conditions such malrotation and Meckel’s diverticulum.
• Necrotizing enterocolitis: A complication of prematurity that leads to the death of intestinal tissue.
• GI conditions: Chronic inflammatory GI diseases that cause intestinal stricture, such as Crohn’s disease. Small bowel obstruction, which encompasses intussusception and related conditions like intestinal pseudo-obstruction.
• Hernia: Incarcerated abdominal hernia, which in extreme circumstances may impair intestinal blood flow.
• Trauma: This is such as accidents that cause your small intestine to become perforated.

Risk

The following includes the possible risk for small bowel resection:

• An anastomotic leak occurs when the sutures or staples holding the remaining tissue in place come loose.The condition poses a serious threat to life.
• Injuries to surrounding organs, such the pancreas or liver.
• Chronic anemia.
• Hernia, protrusion of intestinal tissue through an incision.
• Persistent diarrhea for weeks.
• Small bowel obstructions.
• Stricture.

Before the procedure

Before undergoing a small bowel resection procedure, several preparatory steps are essential, barring emergencies. These involve undergoing lab and imaging investigations to ensure your overall health status.

Common medications like aspirin, blood thinners, and anti-inflammatory drugs may need to be temporarily discontinued as they can affect the surgery and recovery process.

Additionally, a bowel cleanse is typically required in the days leading up to the surgery. This involves consuming meals rich in fiber and staying hydrated to facilitate regular bowel movements. In preparation for the procedure, transitioning to a clear liquid diet is necessary. In some cases, laxatives or an enema may also be recommended to ensure the bowel is adequately cleansed.

During the procedure

During the surgery, the patient might expect the following:

• You receive anesthesia which provide a temporary block sensation and put you to sleep.
• If your surgeon is doing a robotic or laparoscopic operation, one or more tiny incisions will be made. The surgeon creates a single, sizable incision during an open surgery procedure.
• Your surgeon reaches the portion of your small intestine that is affected.
• They remove the diseased tissue after placing clamps on either side of it.
• In the event of an obstruction, revascularization, or blood vessel repair, may be required for restoring your intestines’ blood supply.
• Your surgeon closes the incision and applies a dressingwhen the surgery is finished.

Following the removal of the dead tissue by my surgeon, this occurs.

• Anastomosis: Using staples or sutures to join the ends of intestinal tissue that are in good condition.
• Ileostomy: If there is insufficient tissue for connection, your surgeon makes an incision on the outer surface of your abdomen. Your small intestine then discharges through this opening into a specialized bag affixed to your skin.

It usually takes several months to recover. But within a few weeks, the majority of patients feel well enough to go back to their regular activities.

After the procedure

After the small bowel resection procedure, patients typically spend several days in the hospital. Initially, oral intake is restricted as the intestines require rest. Instead, patients receive enteral nutrition through tube feeding to ensure adequate nutrient intake. As recovery progresses and the patient’s condition improves, they can gradually transition to consuming liquids and soft meals orally.

Upon discharge from the hospital, it’s important to allocate a few more days for rest at home. Engaging in light activities such as walking and getting out of bed regularly is crucial to prevent the formation of blood clots.

Additionally, follow-up appointments with the surgeon are essential to monitor the healing process and ensure everything is proceeding as expected.

Outcome

Resection surgery might prevent the progression of severe gastrointestinal problems. This may help you avoid undergoing more involved procedures, such as a larger resection. Preserving as much intestinal tissue as you can will help prevent off possible complications such as short bowel syndrome.

Prolonged relief can be achieved after a resection. The treatment may be beneficial for congenital disorders and severe traumas. But sometimes it’s not a long-term solution. A second resection may occasionally be necessary due to the recurrence of conditions like hernias and Crohn’s disease.

If you encounter the following, you may need to get in touch with your healthcare provider.

• Blood or pus leaking from the wound.
• Frequently occurring nausea and vomiting that affects one’s ability to swallow food or liquids.
• Having problem with bowel movement.
• Infection-related symptoms, such as fever or warm skin around the wound.
• Pain that is not relieved by medicine.