The small bowel is responsible for the primary absorption of nutrients into our body. Its length is approximately 3-4 meters. The small bowel consists of the duodenum, jejunum, and ileum. There are cases where partial resection of the small bowel is necessary, as long as the resection is not extensive and there is enough remaining length (about 2 meters of small bowel). In such cases, there are no significant implications for food absorption. The surgery can be performed through an open incision or using a laparoscopic technique.
Possible reasons for partial small bowel resection include bleeding, infection, ulcers in the small bowel, tumors, pre-cancerous polyps, Crohn's disease, bowel obstruction, or injury.
As with any invasive procedure, complications may occur, with the most common being excess bleeding, infection, bowel obstruction due to scar tissue, and the formation of hernia at the incision site. Previous abdominal surgeries may increase the risk of complications.
Before the surgery, a physical examination, blood and urine tests, X-rays of the chest and abdomen, and additional imaging such as CT or MRI of the abdomen will be conducted.
It is essential to inform the doctor about any regularly taken medications. The doctor may ask to stop certain medications, such as aspirin, anti-inflammatory drugs, steroids, and blood thinners like Plavix or Coumadin, for about a week before the procedure. Additionally, the doctor may recommend specific medications to prepare for the surgery, including antibiotics. Follow the doctor's instructions accordingly.
As part of bowel preparation for the surgery, in the week before the procedure, it is recommended to consume fiber-rich foods and drink 6-8 glasses of water per day to encourage bowel activity. Other bowel cleansing methods may include laxatives, enemas, or fluids that aid in clearing the bowels (such as Miralax or PicoPrep). It is forbidden to eat or drink a few hours before the surgery.
The surgery is performed under general anesthesia. A catheter will be inserted into the bladder for urine drainage, and in some cases, a nasal tube (zonde) for stomach drainage might be used. These tubes will be removed after a few days, depending on the surgeon's decision and the patient's condition after the surgery.
During the surgery, the affected section of the small bowel is cut and the ends are joined to restore continuity of the digestive system. In some cases, a temporary or permanent stoma may be created.
The incisions in the abdomen will be closed with sutures or staples, which will be removed if necessary after about two weeks.
The average hospital stay after the surgery is 5-7 days, depending on the medical consideration.
Before discharge, the doctor will provide instructions regarding activities during the healing period to ensure a complete and smooth recovery. At first, avoid heavy lifting and strenuous activities. Do not drive unless the doctor gives permission. Do not immerse the surgical area (meaning no swimming pool or Jacuzzi) and avoid full baths until the doctor approves it.
It is important to get up and walk to prevent blood clots.
If a stoma has been created, the nursing staff will provide instructions on changing the bag to maintain personal hygiene.
After discharge from the hospital, seek medical attention if any of the following symptoms occur:
Signs of inflammation, including fever and chills
Redness, swelling, drainage, or delayed wound healing at the incision site
Spongy drainage with blood
Sutures or staples coming undone
Nausea or vomiting that cannot be controlled by medications, or lasts more than two days after discharge
Persistent abdominal pain or bloating
Constipation or diarrhea
Bleeding from the stoma or black stool
Uncontrolled pain not managed with oral pain relief
Coughing, shortness of breath, or chest pain
Pain, burning, urgency, or frequency during urination, or persistent urine leakage
New symptoms