• A colon resection is the removal of large intestine.  This is usually done for colon cancer, benign tumor or an infectious process.  For most colon resections the pt will spend in the hospital 5-7 days awaiting bowel function to resume.
• I perform the operation either open (large midline incision),  laparoscopically, or robotic (smaller incisions).  Every case has to be considered in a case by cases basis.  We will always try to pick the least invasive procedure.  The recovery is slightly shorter for the laparoscopic surgery due to the smaller incisions.  The hospital stay is pretty much the same since the limiting factor is the return of bowel activity which is 4-5 days, and not the size of the incision.
• When the operation is done electively and under controlled circumstances with a bowel prep, the doctor will put the bowel together.  This is called anastomosis.  It is done using a stapling device or hand sewn.
• If the operation is done under emergency situation with infection, colon rupture or unprepared colon, the surgeon will create a colostomy.  This process involves exteriorizing the colon and placing a bag over the opening.  This may be a temporary bag or permanent depending on the situation and procedure performed..
  Before a colon resection a bowel prep should be done.  This consists of a preparation that will give you diarrhea and cleanse the colon.  Also antibiotics are given by mouth and in the IV when the pt arrives to the hospital.  Below is the instructions for the bowel prep.  The antibiotics are given by mouth during the bowel prep.
• For this operations general anesthetic is used and the pt can have a epidural or back catheter for pain control after the surgery.  This is strongly recommended if not contraindicated.  Discuss with your anesthesiologist.
• After the operation there will be a tube in the nose called the nasogastric tube (ng tube)  this tube is very important to maintain the bowel decompressed and protect the recently created anastomosis.  The tube will be in place, until bowel activity is evident by  bowel movement or passing of gas.
  

Risks of the Procedure

• Wound Infection
•  Intra-abdominal abscess (infection inside the abdomen)
• Anastomosis breakdown (bowel hook up leaks)
• Hernias – weakness of the abdominal wall
• Recurrent tumor – cancer comes back
• Bleeding

The complications stated above are the most commonly seen.  There may be other problems that can happen like blood clots in the legs or lungs, pneumonia and the complications associated with anesthesia.  The pt should discuss these with the anesthesiologist.  If any complication occurred, we would take care of it and do the best to resolve the problem.  We are well aware of the possibility of complications, take precautions to prevent them and have the knowledge to address them when they occur.

Instructions for Bowel Prep
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Instructions for Bowel Prep Antibiotics

Usually Two Antibiotics Are Given By Mouth The Day Before The Procedure , Erythromicyn And Neomicyn
The Dose Is The Same For Both.  That Is On Gram.  The Pt Takes Three Doses At 1pm, 2pm And 11pm The Day Before The Procedure At The Same Time The Half Litely Is Been Taken. 

Before Surgery

1. Shower the night before with regular soap
2. Do not shave any part that will be operated on.  this increases risk of infection.
3. Avoid smoking 1-2 weeks before the procedure.  It helps the
   recovery time, wound healing and the recovery from anesthesia
4. Avoid alcoholic beverages at least 48 hours before the surgery.
5. Do not bring any valuables to the center or hospital
6. If you are going home arrange for drop off and pick up
7. Get a good night rest the night before surgery
8. Make sure you have stopped all blood thinners at least 5-7 days  before surgery.  this includes
   aspiring, plavix, coumadin, fish oil, vitamin E (large doses), or any non steroidal anti-inflammatory agent
9. If you are having bowel surgery make sure that you have taken a bowel prep with antibiotics.
10. If you have any questions call 281-737-0970.

After Surgery

1. Make sure that you have a follow up appointment fo 7-10 days.  Call 281-737-0970 for one
2. If it is a closed wound then the wound can and should be washed every day starting 24 hr
   after the operation.  Do not use peroxide or any other substance, just use water and soap.
3. For open wounds, if packed then remove the packing every day and wash in shower every
   day.  Repack after washing and cover.
4. If the wound has a drain then empty the drain every day and measure and record the amount.
   Bring the amounts to the post op appointment.
5. Call your doctor if bleeding, redness, ferver or any other symptom develops
6. Start diet slowly since anesthesia can cause nausea and vomitting
7. Stay active and ambulate daily, several times a day and take deep breaths.
   (this is specially imporant for major surgeries)
8. Stay hydrated and eat healthy.
9. Do not start any blood thinners, aspirin or aspirin like products for 5 days after surgery.
10. Call your doctor if any instruction is unclear or if you have any questions at all.
11. If your had bowel surgery, diarrhea can be experienced, but if diarrhea is not improving
    then call yur doctor immediately.  Avoid anti-diarrheasl unless your doctor tells you it is ok to take.