Colon & Small Bowel Surgery

Colon Surgery

Surgery may not always be the cure for colon disease, but it is generally the best way to stop the disease from spreading and help alleviate pain and discomfort. Over 600,000 surgical procedures are performed each year in the United States to treat colon disease.

Our surgeons provide surgical care for the following colon disorders:

What is the Colon?

The colon is also known as the large intestine or large bowel. It is located in the lower part of the digestive tract. It is a muscular tube about five feet long that travels around the borders of the abdominal cavity. This long tubular organ consists of the colon (large intestine)and the rectum, which is the last part of the colon.

Once food is swallowed it starts to become digested in the stomach. Following that, it empties into the small intestine, where the nutritional part of the food is absorbed. The remaining waste then travels through the colon into the rectum. The colon and rectum absorb water, form stool, and hold the waste until you are ready to expel it.

Muscles run across and around the colon. They will contact and relax rhythmically in order to propel the stool along. Water is absorbed along the way as the stool goes from a liquid to a solid. The route it travels is up the ascending (right) colon, across the transverse colon, and down the descending (left) colon to the curved and looped sigmoid colon. Stool is stored there until such time that it is conveniently passed outside. It will exit through the anus. Located at the base of the rectum, which is the last six inches of the colon.

Colon Problems

Symptoms of Colon Problems

The following symptoms can be caused by tumors, polyps and diverticula. Patients should look for theses as possible indications that a colon disorder may exist:

In some cases, surgery is essential to determine if a growth is cancerous. Colon surgery is recommended to remove tumors, large or hard to reach polyps or diverticula that are causing symptoms of colon disorder. If a tumor or abnormal growth is removed, lymph nodes in the mesentery will be tested along with the tumor or growth to determine if cancer is present and if it has spread. Other organs including the liver will also be examined to determine if there is a presence of cancer.

The Procedure (Colon Resection)

Colon surgery is performed to remove the affected section of the colon. The portion of the colon above the area that is resected is then reattached to the portion of the colon just below the resected area. This “re-attachment” is called an anastomosis and it is accomplished with the use of a suture and stapling device. This procedure can last on average for 2 – 4 hours, and possibly more depending on the amount of the colon that has to be removed, the amount of previous scarring and the technique used.

Only when it is absolutely necessary will a colostomy or ileostomy (upper small intestine opening) be constructed during colon surgery.
This will allow the colon to recover or heal before it is rejoined a few months later. Rarely will the colostomy be permanent. However, if it will be permanent, this will be discussed extensively with the patient prior to surgery. With a colostomy, body wastes are eliminated directly through an opening of the colon in the abdomen, where the stool is collected into a special appliance. If you have the need for this, you will be trained in the use and care of it prior to leaving the hospital. There are many resources available, including specially trained ostomy nurses that can work with the patients to manage ostomy care.

Laparoscopic Colon Resection

Most laparoscopic colon resections are performed through 5 – 6 small incisions that are about a quarter inch in length. A canula, a narrow tube-like instrument is used to enter the abdomen. A laparoscope, a tiny telescope connected to a video camera, is inserted through the canula, This presents your surgeon with a magnified view your internal organs on a high definition television monitor. Several other canulas are inserted through the incisions to allow your surgeon to work inside the abdomen and remove part of the colon.

Advantages of Laparoscopic Colon Resection

Open Colon Surgery

The traditional”open” procedure is highly invasive and patients often require a longer recovery period. Generally, open colonic surgeries require long incisions. This can result in a hospital stay of 5 – 8 days and may require a 6 week recovery period. The factors that may cause the surgery to be performed with the open method include:

Possible Complications

There are risks of complications with this procedure as there is with any surgery. These include:

Colon Cancer

Colon cancer is one of the most common forms of cancer, and when it is caught in the early stages, it is one of the most treatable forms of cancer.

Colon cancer occurs when cancerous growths, or polyps, form in or around the colon. All polyps are not cancerous. Symptoms will vary depending on the location of where the cancer develops. They can include blood in the stool, weight loss and abdominal pain. There are circumstances where patients will present no symptoms. Treatment for colon cancer will depend on various factors including the part of the colon that is affected and the stage of the disease.

Treatment plans can include the following:

Small Bowel Obstruction Surgery

A bowel obstruction will occur when the small bowel (small intestine) or large bowel (large intestine) is partially or completely blocked. This blockage will prevent food, fluids and gas from moving through the intestines in a normal process and could cause severe pain that comes and goes.

Obstructions can be a result of:

When the symptoms for small bowel obstruction appear it is an indication of a blockage in the intestines and an abnormality in the digestive process. Most of the time bowel obstruction will be a medical emergency and require surgery. One out of every four acute surgical admissions in the United States is caused by small bowel obstruction.

If it is left untreated, a small bowel obstruction can lead to peritonitis, perforation, and intestinal abscesses. This is fatal in 100% of the cases when untreated. When severe cases of small bowel obstruction are taken care within a 36 hour period, then there is a 92% chance that the patient will live. After 36 hours the percentage can decrease to 75%.

Most bowel obstruction cases cannot be prevented if there is no mechanical cause for the obstruction. In those cases where there is an underlying cause of a related condition, treating that cause may help prevent complications that can lead to small bowel obstruction. In order to prevent problems, it is important that the patient seek medical help as soon as obstruction symptoms occur.

Symptoms

Symptoms can vary depending on the level of obstruction.
They include:

Laparoscopic Colon Resection

Most laparoscopic colon resections are performed through 5 – 6 small incisions that are about a quarter inch in length. A canula, a narrow tube-like instrument is used to enter the abdomen. A laparoscope, a tiny telescope connected to a video camera, is inserted through the canula, This presents your surgeon with a magnified view your internal organs on a high definition television monitor. Several other canulas are inserted through the incisions to allow your surgeon to work inside the abdomen and remove part of the colon.

Advantages of Laparoscopic Colon Resection

Open Colon Surgery

The traditional “open” procedure is highly invasive and patients often require a longer recovery period. Generally, open colonic surgeries require long incisions. This can result in a hospital stay of 5 – 8 days and may require a 6 week recovery period. The factors that may cause the surgery to be performed with the open method include:

Possible Complications

There are risks of complications with this procedure as there is with any surgery. These include:

A leak where the two sections of the colon were reconnected

 

Colon Cancer

Colon cancer is one of the most common forms of cancer, and when it is caught in the early stages, it is one of the most treatable forms of cancer.

Colon cancer occurs when cancerous growths, or polyps, form in or around the colon. All polyps are not cancerous. Symptoms will vary depending on thelocation of where the cancer develops. They can include blood in the stool, weight loss and abdominal pain. There are circumstances where patients will present no symptoms.

Treatment for colon cancer will depend on various factors including the part of the colon that is affected and the stage of the disease.

Treatment plans can include the following:

Small Bowel Obstruction Surgery

A bowel obstruction will occur when the small bowel (small intestine) or large bowel (large intestine) is partially or completely blocked. This blockage will prevent food, fluids and gas from moving through the intestines in a normal process and could cause severe pain that comes and goes.

Obstructions can be a result of:

When the symptoms for small bowel obstruction appear it is an indication of a blockage in the intestines and an abnormality in the digestive process. Most of the time bowel obstruction will be a medical emergency and require surgery. One out of every four acute surgical admissions in the United States is caused by small bowel obstruction.

If it is left untreateda, small bowel obstruction can lead to peritonitis, perforation, and intestinal abscesses. This is fatal in 100% of the cases when untreated. When severe cases of small bowel obstruction are taken care within a 36 hour period, then there is a 92% chance that the patient will live. After 36 hours the percentage can decrease to 75%.

Most bowel obstruction cases cannot be prevented if there is no mechanical cause for the obstruction. In those cases where there is an underlying cause of a related condition, treating that cause may help prevent complications that can lead to small bowel obstruction. In order to prevent problems, it is important that the patient seek medical help as soon as obstruction symptoms occur.

Symptoms

Symptoms can vary depending on the level of obstruction. They include:

Surgery

Surgery is performed to relieve a bowel obstruction. If a blockage exists for an extended period of time, it can restrict the blood flow to part of the bowel, causing the bowel to die.

Laparoscopic Small Bowel Resection

Most laparoscopic colon resections are performed through 3 – 5 small incisions that are about a quarter inch each.
A canula, a narrow tube-like instrument is used to enter the abdomen. A laparoscope, a tiny telescope connected to a video camera, is inserted through the canula. This presents your surgeon with a magnified view of the patient’s internal organs on a high definition television monitor. Several other canulas are inserted through the incisions to allow your surgeon to work inside the abdomen and remove part of the small bowel.

The part of the small bowel that is diseased is located and removed. Clamps are used on both ends of the diseased part to close it off. The healthy ends of the small bowel are then reconnected, sewn or stapled together. This procedure can take up to one to four hours.

In the event that there is not enough healthy small bowel to reconnect, then an opening (stoma) is made through the skin of the belly. The small bowel is then attached to the outer wall of the belly. Stool will pass through the stoma into a drainage bag outside of the belly. This is called an ileostomy and may be either temporary or permanent.

Advantages of Laparoscopic Small Bowel Resection

Open Small Bowel Resection

The traditional “open” procedure is highly invasive and patients often encounter a longer recovery. Generally, this surgery will require a cut of about 6 inches long in the mid-belly that results in a hospital stay of 5 – 8 days and may require a 6 week recovery period. Once the incision is made the same procedure to remove the obstruction laparoscopically is followed from this point on. The factors that may cause the surgery to be performed with the open method include:

Surgery Risks

In addition to the risks that exist for any surgery, specific risks for this surgery include:

Why the Small Bowel Resection is Performed

Small bowel resections are suggested for the following:

Prevention

Diet modification and lifestyle change may possible reduce some forms of bowel obstruction. These include:

Preparing for Colon and Small Bowel Surgery

After Colon and Small Bowel Surgery

You will be sent to a recovery room after the surgery and transferred to a regular hospital room when your vital signs are stable. Your family will be permitted to visit with you when you are in the room. Pain medication will be made available.

You may find a thin plastic tube in your nose that will go down into your stomach to remove any air or fluid that could make you sick or uncomfortable. As soon as your bowels start working, usually 4 – 5 days after surgery, the tube will be removed. Once the tube is removed you will start on a liquid diet and eventually advanced to regular food when you are capable of tolerating it.

You will be assisted out of bed the morning after surgery and activities will gradually be introduced. It is important to do so in order to prevent complications like blood clots and pneumonia. Your abdomen might be slightly bruised and swollen. You may also have metal clips or staples on the surface depending on the type of procedure you had.

You will have to a make a follow up appointment to check your progress and address any issues you may have.

At Home After Colon and Small Bowel Surgery

When to Call the Doctor After Colon and Small Bowel Surgery

Laparoscopic & Single Incision Surgery
Laparoscopic & Single Incision Surgery
Acute Care Surgery
Acute Care Surgery
Surgical Oncology
Surgical Oncology
Cosmetic Procedures
Cosmetic Procedures

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Our Locations

Norwalk

148 East Avenue, Suite 3a
Norwalk, CT 06851
203-899-0744

Shelton

2 Trap Falls Road, Suite 100
Shelton, CT 06484
203-256-9707

Stamford

778 Long Ridge Road, Suite 101
Stamford, CT 06902
203-348-0589

North Haven

52 Washington Avenue, Suite 3
North Haven, CT 06473
203-285-2861

Milford

831 Boston Post Road, Suite 202
Milford, CT 06460
203-647-0140

Bridgeport

Surgical Center of Connecticut
4920 Main Street
Bridgeport, CT, 06606
203-371-2986