A small bowel resection is a surgical procedure in which at least one portion of the small bowel, or small intestine, is removed. The small intestine is made up of three segments: the ileum, the duodenum and the jejunum. In a small bowel resection, one or all of these segments might be removed. This surgical procedure is carried out as a treatment for chronic bowel diseases and certain types of cancer.
Diseases such as Crohn’s disease and ulceration of the small bowel can cause such serious damage to the segments of the small intestine that they no longer function correctly. When this occurs, the damaged segments must be removed to allow the digestive system to return to a more normal state of function. Small bowel cancers, including sarcoma, lymphoma and adenocarcinoma, are most often treated via surgical removal of the tumor. In some cases, at least one segment of the small intestine might also be removed.
Small bowel resection can be carried out laparoscopically or via the open surgery method. In open surgery, an incision of approximately 6 inches (15 cm) is made in the abdomen. The layers of skin, fat and muscle are retracted to allow the surgeon to locate the diseased areas of bowel. These diseased segments are clamped and then cut and removed.
In laparoscopic small bowel resection, between three and five much-smaller incisions are made in the lower abdomen. These incisions provide access for surgical tools, a light source and a small camera that transmits images of the interior of the abdomen onto a monitor. The surgeon then uses the monitor to help him or her manipulate the surgical tools to perform the procedure.
After the diseased segments of bowel are removed, the surgeon joins the healthy ends of the bowel together by sewing or stapling them. Sometimes, there is not enough healthy small intestine tissue remaining to perform this part of the procedure. In these cases, the surgeon makes a stoma, or hole, in the abdomen and attaches the end of the small intestine to the stoma. After the patient resumes eating, stool passes through the small intestine to the stoma and to an external drainage bag. This procedure, called an ileostomy, provides a means for stool to exit the body when the small bowel cannot be reconnected.
The entire procedure lasts one to four hours, depending on how much of the small intestine must be removed and whether an ileostomy is needed. After undergoing a small bowel resection, most patients stay in the hospital for three to seven days, depending on whether the operation was open or laparoscopic. Generally, people who undergo laparoscopic surgery can return home sooner and will make a full recovery more quickly than those who undergo open surgery.
