Small Bowel Resection (Small Intestine Surgery, Ileum Surgery)

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Definition

Surgery to remove a diseased or cancerous part of the small intestine (small bowel, duodenum, jejunum, and/or ileum). The surgery can be performed through a traditional, open incision, or using a laparoscopic technique, involving several smaller keyhole incisions.

The Small Intestines

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Parts of the Body Involved

Abdomen, small intestine

Reasons for Procedure

This procedure may be done to treat the following conditions:

  • Bleeding, infection, or ulcers due to inflammation of the small intestine
  • Cancer
  • Crohn's disease
  • Intestinal blockage
  • Injury
  • Precancerous polyps

Risk Factors for Complications During the Procedure

Previous abdominal surgery is the only known risk factor for complications.

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Blood tests
  • Urine tests
  • X-rays of the chest and gastrointestinal tract

In the days leading up to your procedure:

  • Do not take aspirin, aspirin-containing medications, or ibuprofen before your surgery. If you take any of these drugs on a regular basis, ask your doctor how long before the surgery you should stop taking them.
  • Take antibiotics for several days before surgery, if recommended by your doctor.
  • Your intestines should be cleaned out for the surgery. During the week before surgery, eat high fiber foods and drink 6-8 glasses of water per day to encourage bowel movements. Other cleansing methods may also be recommended, including enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution that helps with the complete emptying of your intestines.
  • Begin fasting as directed by your doctor.

During Procedure

Anesthesia will be administered. A bladder catheter will be inserted. A tube will be inserted through the nose to drain accumulated fluids and acid from the stomach (nasogastric tube)

AnesthesiaGeneral anesthesia is administered for this procedure. Description of the ProcedureTraditional pen incisionan incision is made into the abdomen in the area of the diseased intestine.Laparoscopic techniquecarbon dioxide gas is pumped into the abdomen through a tiny incision, often near the navel. A number of tiny incisions are made in the abdomen through a fiberoptic scope (called a laparoscope) and the surgical instruments are inserted. The laparoscope sends a view of the interior of the abdomen onto a video monitor.In either type of surgery, once the abdomen is accessed the small intestine is clamped above and below the diseased section. This section is cut free and removed.Depending on how much intestine is left and the health of the remaining intestine, the surgeon may be able to join the free ends of the intestine together. Otherwise, a permanent or temporary ileostomy is created to divert the intestine's waste products while it is healing. An ileostomy creates an opening (called a stoma) in the abdomen. The end of the small intestine closest to the stomach is attached to the opening. This allows intestinal contents to drain into a sealed pouch on the outside of the body. If a temporary ileostomy is created, another operation will be necessary several months later to reverse the ileostomy. In this procedure, the two healthy ends of the intestine are joined. The abdomen is then closed with stitches, which are removed one week after surgery.
After ProcedureBladder catheter and nasogastric tube will remain until you are able to eat and go to the bathroom normally. How Long Will It Take?The procedure takes about 1-4 hours. Will It Hurt?Anesthesia prevents pain during the procedure. Possible ComplicationsBulging through the incision, called an incisional herniaNarrowing of the stomaBlockage of the intestine caused by scar tissueExcessive bleedingInfection Average Hospital StayA 5-7 day stay is required after this surgery. Postoperative CareRest in bed for several days.Move and elevate your legs often to prevent blood clots.When your doctor approves, gradually increase activity.Eat only ice chips and liquids until your stomach begins to produce bowel sounds (such as stomach growling). Then, you may begin eating soft foods, and gradually add more foods until you can handle a normal diet. OutcomeThe final outcome depends on the state of your disease. However, after a recovery period of about 4 weeks, your intestinal problems should improve. Call Your Doctor If Any of the Following OccursPersistent abdominal pain or bloatingSigns of infection, including fever and chillsInability to keep food downConstipation or frequent diarrheaStitches or staples come apartBandage becomes soaked with bloodRectal bleedingBlack, tarry stoolsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteCough, shortness of breath, chest pain, or severe nausea or vomitingPain, burning, urgency, or frequency of urination, or persistent bleeding in the urine RESOURCES:
American College of Surgeonshttp://www.facs.org National Cancer Institutehttp://www.cancer.gov CANADIAN RESOURCES: The Canadian Association of Gastroenterology (CAG)http://www.cag-acg.org/default.aspx Canadian Cancer Societyhttp://www.cancer.ca References: Mayo Clinic website. Available at: http://www.mayo.edu/ . National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ . Last reviewed March 2008 by Daus Mahnke, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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