Surgery to the bowel may be necessary in the case of either medical emergencies or for medical conditions affecting the bowel.
The most common small bowel conditions that may require surgery include:
- Small bowel obstruction – due to adhesions, hernia, tumour, radiation, Crohn’s disease
- Small bowel tumour – primary adenocarcinoma, GIST (gastrointestinal stromal tumour), NET (neuroendocrine tumour or carcinoids), lymphoma and secondary tumour
- Small bowel perforation – due to foreign body, ischaemia due to obstruction
- Ischaemic gut (SB ischaemia secondary to embolus/ thrombus to superior mesenteric artery)
The most common small bowel conditions that may require surgery include:
Read more about common bowel conditions here.
Small Bowel Resection and division of adhesion – open or laparoscopic
The small bowel connects the stomach to the colon. It has three sections, the duodenum which is connected to the stomach, the jejunum below it and below the jejunum the ileum which is joined to the colon. Its role is to extract nutrients from food that has been digested in the stomach.
This surgical procedure involves the removal of part of the small bowel, which may be necessary.
The common large bowel conditions that may require surgery include:
- Colon cancer causing obstruction/ perforation, anaemia, malignant polyp
- Complicated appendicitis
- Complications of acute diverticulitis such as perforation, stricture, fistula and rarely bleeding
- Sigmoid volvulus
- Complicated appendicitis
- Ulcerative colitis/ Crohn’s disease
Left / Right Hemi Colectomy
A ‘Hemicolectomy’ is literally the removal of a half section of the colon. A right hemicolectomy is the removal of a section of the colon on the right of the body (which is the section connected to the small intestine) and this includes the ‘caecum’ and the appendix. An anastomosis - a join - is made between the remaining section of colon and the small intestine. On occasion it may also be necessary to remove a section of the transverse colon (the horizontal section of the colon that crosses the abdomen) and this procedure is then referred to as an ‘Extended Right Hemicolectomy’.
A left hemicolectomy is the removal of a section of the colon on the left of the body - this is the final section of the colon that joins the rectum. The affected section of the colon is removed by the surgeon and a join is made between the remaining section of colon and the rectum. Sometimes the rectum must be removed at the same time, then it is referred as anterior resection. Hartmann’s procedure is a common emergency large bowel resection and formation of end-colostomy for perforated sigmoid diverticulitis or malignant large bowel obstruction.
