Bowel Surgery

Surgeries performed by our colorectal and general surgeons include:

• Colectomy - removal of part of the colon  or rectum e.g. right hemicolectomy and anterior resection.
• Colostomy - creation of a stoma /bowel bag.
• Endoscopic Surgery - some/most of these operations can be done by keyhole surgery to a degree - see below.
• Inflammatory bowel disease surgery
• Haemorrhoidectomy
• Botox to anal fissure
• Anal fistula surgery

Prior to your surgery Kensington Hospital will provide you with instructions on when you should stop eating and drinking.  Your stomach must be empty for at least 6 hours in order to make the general anaesthetic safe. They will also give you directions where to present for surgery and your actual admission time.

If you take tablets to thin the blood such as Aspirin, Warfarin or Clopidogrel, then you need to let your surgeon know as they may need to be stopped prior to surgery.

Depending on your operation you may need a bowel clear out or enema before your operation.

It is okay to continue to take your regular medication with a small sip of water on the morning of your surgery. 

Also refer to Kensington Hospital patient information available here - https://www.kensingtonhospital.co.nz/patient-information/

There are two main ways you can have bowel surgery. These are keyhole (laparoscopic) surgery or open surgery.

In keyhole (laparoscopic) surgery, your surgeon will make small cuts and a slightly larger cut in your abdomen. They do the operation by putting small instruments and a tube-like telescopic camera through the smaller cuts and removing the appropriate section of bowel through the larger cut. Images from the camera are shown on a monitor so your surgeon can see what they are doing. People often recover more quickly from this type of surgery, may have less pain afterwards, and don’t have to stay in hospital for so long.

In open surgery, your surgeon will make a single, large cut into your abdomen to reach your bowel.

The choice of procedure will depend on where the diseased parts are. Your surgeon will also consider if you have had surgery on your abdomen before.

Your surgeon will remove the diseased parts of your bowel and will join the two healthy ends together using stitches or staples. This is called an anastomosis.                                                                                                                           

Some people need to have a stoma. This is where a section of bowel is brought out through an opening on your abdominal wall.  This part of the bowel then empties into a bag which is stuck onto your skin (stoma bag). This then involves you regularly emptying or changing this bag. You may have a temporary stoma to let your bowel rest after surgery. Some people may need a permanent stoma, for example if the remaining ends of bowel can’t be joined together.

Patients with ulcerative colitis may have an ileoanal pouch after they’ve had their large bowel and back passage removed. A ‘pouch’ is created in your bottom that does the same job of storing waste as the rectum would. 

Your surgeon can provide further information.

Like any major operation, bowel surgery has risks.  Complications may include infection, bleeding, blood clots, damage to nearby organs, or leaking from the joins between the removed parts of the bowel.

Some ways you can prevent complications after surgery include:

• Drink plenty of fluids to prevent dehydration.
• When comfortable to, walk around frequently to prevent blood clots.
• Wash your hands before and after touching the area around your incision site(s)
• Don’t lift more than 4 kg for at least 6 weeks.
• Change your bandages as directed.
• Avoid wearing tight clothing that could rub against the incision.

You’ll usually need to stay in hospital for between three and seven days if you have bowel surgery without any complications.

Many people find that their bowel and bladder functions change. Immediately after surgery you may be on a modified diet and some foods may cause discomfort, wind or diarrhoea.  These changes usually improve within a few months but, for some people, it can take longer. 

After surgery, key symptoms to watch out for are:

• fever or chills
• increasing pain or redness around the incision
• drainage from the incision site(s)
• diarrhoea or constipation and not passing a bowel movement for 2-3 days after surgery.
• Vomiting for three days or more.

If you get any of these, contact your doctor or surgeon straight away.

Your return to work depends on the type of surgery you have, how you are feeling and the type of work that you do. If you have a very active job that requires lifting, you are likely to need eight weeks off work. If you have a sedentary job (such as working in an office), you may go back earlier. It is recommended to avoid lifting any heavy objects for at least 6 weeks following your surgery

You will have a follow-up appointment with your surgeon approximately six weeks after your surgery to assess your recovery, discuss any concerns that you may have and to review any pathology from your procedure. 

If you have any concerns or problems prior to this appointment, please contact our rooms to discuss.  If you are acutely unwell then you need to go to your nearest hospital emergency department and leave a message with our rooms.