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Major Bowel Surgery

Overview

Major bowel surgery is where a section of the bowel (colon) has to be removed most commonly due to either bowel cancer, inflammatory bowel disease or diverticular disease. The procedure may be carried out using laparoscopic, robotic or open surgical approaches. Dr White will be able to advise of pros and cons of these approaches in each patient's individual case.

How should I prepare for surgery?

The day before admission we will contact you to confirm admission time and to give you instructions regarding any fasting requirements for the procedure. You should bring any x-rays in with you (and ensure you take them with you when you are discharged). Also bring any current medication in with you to the hospital.

For day procedures you should not drive yourself home when you are discharged – please ensure you have made other transport arrangements.

If you smoke, you should reduce smoking before your procedure. Our strong recommendation is that you give up entirely at least 6 weeks before the procedure, or at least one week beforehand. Smoking greatly increases the possibility of chest infection and hampers natural wound healing.

In the case of major surgery, please inform Dr White's team if you take:

  • Warfarin.
  • Aspirin.
  • Plavix.
  • Anti-inflammatory medication.

We will need to discuss these medications with you prior to your surgery.

Dr White will provide you with a full set of pre-operative instructions for your specific surgery well ahead of the day of surgery.

Recovery Guidelines

Hospital Stay

After major bowel surgery a hospital stay of 5-7 days is to be expected. Patients who are elderly or do not have someone to look after them during recovery at home may need to stay in hospital longer.

Food Intake

Often patients are recommended to follow a low fibre diet during the eight-week period after surgery, which lessens the stress on the bowel. At the same time patients who have undergone major bowel surgery are recommended to consume food in smaller portions than they are used to and to take extra care to chew all food well before swallowing.

Wound Care

Dressings are applied to any incisions made during surgery. These can be taken off five days after surgery. If staples have been used during surgery, these need to be removed 7-10 days after the procedure.

Bowel Movements

Bowel movements should return to normal quickly. Where a stoma has been fitted patients receive full instructions and guidance as to how to use them in the hospital, with community stoma therapists able to provide assistance at home after discharge from hospital. Whether or not laxatives should be used after surgery will depend on the nature of the surgery. Dr White will be able to advise on this point.

Longer Term Recovery

Once patients have returned home it is advisable to engage in regular low-level physical activity (for example walking) – this will speed recovery. Other physical activity, such as sport or manual labour should be avoided for the first month after the surgery, and where the procedure involved open surgery this period will be longer – Dr White will be able to advise you on this.

Driving

You can start driving again three weeks after a laparoscopic procedure and five weeks after a conventional open procedure.

Surgical Risks

All types of surgery are subject to the following risks, which are rare, but can occur:

  • Allergic reaction to medication / anaesthetic.
  • Bleeding.
  • Difficulty breathing.
  • Infection.

Specific to this type of surgery the following risks are also rare, but can occur:

Anastomosis failure

This is where the sections of the colon that have been reconnected do not heal properly or develop an infection at the connection point. More surgery or the fitting of a colostomy may be required.

Bowel / bladder issues

These may be caused by an obstruction or blockage in the colon, or damage may have occurred to ureters (tubes that connect the kidneys and the bladder) during surgery.

Organ injury

Injury or perforation may occur to nearby organs, such as the bladder, kidneys and spleen.

Sexual function (in males)

After this type of surgery in rare cases sexual function may be inhibited i.e. an inability to ejaculate or have an erection.

When you should get in contact with Dr White

Most surgical procedures are uneventful, with minimal complications. However, you need to be aware of the following symptoms as they may indicate a developing serious complication...

  • Fever.
  • Excess bleeding.
  • Difficulty urinating.
  • Severe or increasing pain.
  • If you experience any of these symptoms or have any concerns after your surgery, please contact the rooms on 07 5598 0955 for advice.
  • A post operative appointment will be made for you before you are discharged from hospital. If you are discharged on a weekend, after normal surgery hours or it is not clear what follow up appointments are required, then contact the rooms the next working day to make an appointment.