Bowel Resection: Overview

A bowel resection is when a section of the small or large intestine (the colon) is removed. This is a surgical procedure that’s done in a hospital. It may be used to treat a bowel blockage, Crohn’s disease, diverticulitis, cancer, or bleeding. A bowel resection is a major abdominal surgery for which there may be a need for several weeks of recovery. 

This article will cover the reasons for having a bowel resection and how this surgery is most commonly done.

What Is Bowel Resection?

In a bowel resection, a portion of the bowel (intestine) is removed. Then, the two ends of the bowel are brought back together again. This allows food to move through the bowel again for normal digestion. The section of the bowel that is reconnected is called an anastomosis.

A bowel resection could be scheduled, or it might be done on an emergency basis. Emergency situations for a bowel resection might include a bowel blockage or bleeding. A resection could also be scheduled, such as when done for a chronic illness like Crohn’s disease.

A bowel resection will usually be done by a colorectal surgeon.

Various Surgery Techniques

A bowel resection may be done as an open surgery or laparoscopically. Laparoscopic surgery may also be done as robot-assisted, where a surgeon uses robotic arms to complete the procedure:

• Open surgery: One long incision is made on the abdomen in open surgery. The surgeon will then complete the resection and close up the incision. Open surgery may need a longer recovery time in the hospital and at home.
  
• Laparoscopic surgery: In this type of surgery, several small incisions are made in the abdomen. Specialized surgical tools are used to complete the resection, and then the small incisions are closed up. There may be a shorter hospital stay and recovery time than with an open surgery.

Contraindications

Usually, surgery on the bowel is only used when other options to treat the condition are no longer available or won't be effective. For this reason, there are not any hard and fast rules about who should not have a bowel resection.

Instead, a surgeon will make a decision about the surgery based on each person's health. There may be a need to personalize how and when the surgery is done and what tools and techniques are used. Recovery after surgery might also look different or take longer for people who are seriously ill before having surgery.

Potential Risks

The risks of surgery will be weighed against the risks of not doing the surgery. Some of the risks of bowel resection surgery include:

• Bleeding
• Blood clots
• Infection
• Injury to other organs in the abdomen
• Ileus (the natural motion of the intestine that moves material along slows or stops)
• Leaking at the anastomosis site
• Scar tissue

Purpose of Bowel Resection

A bowel resection is done to treat a problem with the small or the large intestine. This could be due to:

• Bleeding in the intestines
• Blockage (intestinal obstruction)
• Colon or rectal cancer
• Crohn’s disease (a chronic inflammatory bowel disease)
• Diverticulitis (inflamed pouches in the wall of the colon)
  

How to Prepare

If the surgery is scheduled, there will be appointments with the surgeon and any other healthcare professional as needed before the surgery date. The surgeon will advise on what will need to be done in the days leading up surgery. 

An important part of preparing for surgery includes going over medications with the surgeon’s office. There may be a need to stop some drugs or supplements days or weeks before surgery. If that’s the case, a schedule on when to stop taking things before surgery will be given. Antibiotics might be prescribed to take in the days before the surgery.

Some tests may be done before surgery such as blood work and a chest X-ray. This is to make sure that there are no underlying health conditions that could complicate surgery or recovery.

The day before surgery might include preparing the bowel. This could mean using a laxative bowel preparation that helps remove all the stool from the intestines. The surgeon will instruct when to start preparing and prescribe the method. 

There may also be some changes to your diet the days before surgery. Again, the surgeon’s office will give instructions, but it may include moving to a liquid diet in the day or days before surgery and then fasting for some time before the surgery.

A special surgical soap or wash might also be given to use in the shower or bath the day before or the day of surgery.

You will need to prepare for a hospital stay, including arranging transportation to and from the hospital and bringing items you may need.

What to Expect on the Day of Surgery

The surgeon’s office will give instructions on taking medications on the day of surgery. For some medications, taking them with a sip of water may be allowed, but others might need to be stopped until after surgery. No other food or drink will be allowed on the day of surgery. 

At the hospital, some pre-surgery paperwork will need to be completed. This may mean signing consent forms and providing the hospital with insurance information. It might also include providing a phone number for an emergency contact.

An intravenous line (IV) will be started to give fluids and the medications used during surgery, including an anesthetic.

You will be put to sleep with a general anesthetic for a bowel resection. The surgeon will make one or more incisions (cuts) in the abdomen. The intestine is like a long tube. The portion of the bowel that is affected by the disease or condition will be located and cut out. 

The two ends of the bowel on either side of the cut will then be connected. This could be done using surgical staples or stitches (sutures).

Recovery

After surgery, you will wake up in the recovery room. When considered stable and ready to be moved, you will be transferred to a hospital room. Pain medication will be given through an IV, along with any other medications that are needed.

A resection will be an inpatient surgery. After the surgery, there will be a hospital stay of at least two days and possibly several days. People who have a complicated medical history or are quite ill upon having the surgery may have a more extended hospital stay.

You will be given instructions for recovering at home when discharged from the hospital. It’s important to follow them when you return to specific activities like driving and exercise. It may be a few weeks before it’s OK to drive or lift things that are more than a few pounds.

The surgical incisions will need care. Instructions on how to care for them will be given when leaving the hospital. In addition, there may be dressings on the incisions that need to be changed to keep the area clean. Any redness, bleeding, or other discharge should be discussed with the surgeon.

It may be several weeks before recovery will be far enough along to go back to work or school. At every step of recovery, the surgeon will give guidelines on when to start physical activities. The recovery time may be longer with open surgery versus laparoscopic.

Long-Term Care

Most people can expect to return to most normal activities about six weeks after surgery. This could vary based on how sick a person is before the surgery and if any complications happen either at the hospital or home. 

Diet after returning home might be restricted for a time. The surgeon will give instructions on when more foods can be added to the diet.

At first, it might be recommended to avoid fibrous, fried, spicy, or highly processed foods. Over several weeks, more foods can be added to the diet. It’s important to know that restricting foods long-term isn’t usually recommended.

The reason for the surgery will be important in the aftercare plan. You can expect to have several appointments with a surgeon after being discharged from the hospital. After that, there may be a need to keep seeing a specialist, such as a gastroenterologist, regularly.

Summary

Resection surgery may be done for various diseases and conditions of the digestive tract. In this surgery, the affected part of the intestine is removed and the two healthy ends of the intestine are connected again. This surgery is done in a hospital, so there will be a short stay before recovering at home for several weeks.

A Word From Verywell

Resection surgery is major abdominal surgery, which can be scary. Asking questions at every step of the process can help in knowing what will come next.

It can be difficult to deal with being away from work and home for surgery, followed by recovery. Asking for help can make the journey easier. There may be services available before surgery and during the recovery period to help with everything from mental health to recovery at home.