Intestinal Surgery

Intestinal surgery involves operations of the small intestine, the colon and the rectum. Both benign and malignant tumors (cancer), but also inflammation are treated. Bowel surgery is necessary if the disease can not be treated by medication or other procedures. However, if health is compromised or the quality of life of the patient is affected, a bowel surgery is the saving measure.

Most people only register the intestine when it behaves abnormally or when the digestion is disturbed. The intestine is the most important part of the digestive tract: it can reach a length of up to seven and a half meters in adults and has a surface area of ​​around 32 square meters. The gut is also home to an estimated 100 trillion bacteria, which together weigh as much as a pack of flour.

The intestine is divided into the small and large intestine as well as the rectum and anal canal, with each part fulfilling its own function. However, illness or an unhealthy lifestyle can disrupt the functions and lead to an imbalance in the intestine. Surgery is essential for some causes.

In general, the attending doctor recommends surgery if conservative therapy does not bring the desired improvement in the present disease or if the health of the person concerned is acutely endangered. This can be the case with inflammation as well as with benign and malignant diseases. Inflammation such as appendicitis or diverticulitis can justify surgery if a change in diet or antibiotics are no longer sufficient as a treatment. Benign tissue changes such as polyps or adenomas are usually surgically removed. Colon cancer is feared as a malignant bowel disease. If surgery is indicated, the patient can ask for a second opinion to check the diagnosis.

Small intestinal diseases rarely need to be treated surgically. Common small bowel operations include:

  • adenoids
  • adhesions
  • diverticulum
  • mesenterialinfarkte

Polyps are growths of the intestinal mucosa. They protrude into the intestine interior and can degenerate. If it comes to a degeneration, colon cancer is a possible consequence. For this reason, doctors suggest in this case a small bowel surgery and remove the polyps.

Adhesions, however, are adhesions that cause pain and indigestion.

Diverticula are evaginations of the intestinal mucosa. These can become inflamed, which leads to a so-called diverticulitis (diverticulitis). Again, the doctor removes complaints or risks to health.

Mesenteric infarction is another urgent need for small bowel surgery. In the process, a vessel closes in the intestine, whereupon it is not adequately supplied with blood and nutrients. The result is the death of the intestinal tract. For this reason, a mesenteric infarction represents an emergency requiring immediate surgical treatment.

The about 1.5 m long colon is located between the small intestine and anal canal. In this area, it is particularly common to diseases. Colon surgery therefore takes place more frequently than small bowel surgery. The following diseases of the large intestine usually require surgery:

  • appendicitis (appendicitis)
  • diverticulitis
  • carcinomas
  • adenomas
  • adenoids

A carcinoma is a malignant tumor of the epithelial tissue, ie the covering layer of the mucous membrane. Carcinomas are common in the colon. The earlier the colon operation takes place, the higher the chance of recovery. Therefore, the appropriate procedure should be initiated quickly if a carcinoma is present.

Adenomas, on the other hand, are gland-like, benign tumors. They are often in the form of polyps. Adenomas and polyps are basically harmless, but can degenerate into malignant ulcers. Surgical removal is the sure way to prevent a serious condition.

Behind appendicitis is the inflammation of the appendix. He is at the end of the colon in the right lower abdomen. In a bacterial inflammation is either a simple appendicitis (appendicitis simplex) or a destructive appendicitis (appendicitis destructiva) before. The latter is characterized by particularly severe abdominal pain. In both cases, your doctor will recommend immediate removal by abdominal surgery. He does not remove the entire appendix, but only the inflamed appendix. The earlier the cecal surgery takes place, the lower the risk of complications.

Also, the rectum can fall ill, so that an operation is necessary. A common example of a terminal disease is hemorrhoids (jammed vessels). If these are in a high grade, surgical removal will improve. Anal fistulas and anal abscesses are also inflammatory processes in the rectum that the colon surgeon removes surgically.

A laparoscopy is understood as a laparoscopy. A section only a few millimeters in size and a camera allow a view into the interior of the patient. In this way, surgical instruments are introduced and thus operated in the abdomen. Whether gallbladder, cecum, or parts of the colon are removed, surgery remains basically the same in the abdomen. Only access to the abdominal area is different.

Advantages of the minimally invasive approach include considerably less scarring. Furthermore, in the following years, fewer scar fractures develop after the procedure, which occurred relatively frequently, especially with large abdominal incisions. In addition, the patients tolerate the operation better, have less pain and can reactivate faster.

While the gallbladder is now being very successfully minimally invasively removed, making this procedure the standard, worldwide studies have shown that minimally invasive large-bowel removal is the most appropriate for appropriate diseases, but it is not yet widely available as a standard. In Germany, minimally invasive colon removal is mainly performed in recurrent diverticulitis, a common form of intestinal inflammation. Here, the affected colon section is removed and the two bowel ends are reconnected by means of a stapler. Ideally, the patient may be discharged from the fifth day after surgery.

Like any surgery, bowel surgery involves risks and potential complications. For example, during and after bowel surgery pathogenic (pathogenic) germs may get into the wounds, causing infection. Even bleeding into the abdominal cavity can not be ruled out.

If the ends of two intestinal sections are sewn together again, these sutures open in rare cases. This is also possible with the seam to a bowel outlet. The doctor then speaks of an anastomotic insufficiency. One possible consequence of this complication is that intestinal contents enter the abdominal cavity and cause inflammation there. If a patient complains of nausea, pain, or fever following bowel surgery, the doctor will examine him for these complications.

Diarrhea after bowel surgery often occurs when the doctor removes part of the left colon. These patients have to change their diet because the large intestine is no longer sufficiently thickening the porridge. Here a nutritionist helps.

The complications and risks associated with cecal surgery are rather low. If the appendix perforated, so perforated, the risk increases. Bacteria penetrate the bloodstream more easily. For this reason, the appropriate method in appendicitis is removal of the appendix.

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