Small Bowel Surgery

What is the Small Intestine?

The small intestine is a long, narrow, folded or coiled tube extending from the stomach to the large intestine; it is the region where most digestion and absorption of food takes place. It is about 22 to 25 feet long. Nerves lead to the small intestine which control muscular contractions that move food along the tract (peristalsis). Three successive regions of the small intestine are distinguished: duodenum, jejunum, and ileum.

Why Do I Need a Small Bowel Resection?

A variety of conditions can damage your small bowel. In other cases, a portion of it may have a disease or abnormality that requires removal. Sometimes part of your small bowel may be removed to confirm or rule out a disease when a “tissue diagnosis” is required.

Conditions that might require surgery include:

Bleeding, infection, or severe ulcers in the small intestine such as those caused by Crohn's disease.
Blockage in the intestines from acquired scar tissue after prior surgeries, or from abdominal wall hernias.
Noncancerous tumors
Cancer
Injuries to the small intestine
Meckel's Diverticulum: a pouch of intestine

Diseases that cause inflammation in the intestines may also require surgery.

Such conditions include:

Crohn's disease
Ulcerative colitis

How is a small bowel resection performed?

General anesthesia is necessary for this surgery. Depending upon the reason for surgery, the procedure can take one hour or up several hours. Surgery may be performed in an open fashion or through a minimally invasive approach; this depends on a myriad of factors that Dr Paracha will take into account such as reason for surgery, prior surgeries and adhesions, hernias, history of radiation or cancer, physiologic age and functional status, etc. After the diseased portion of intestine is removed, Dr Paracha will have to address each end of the intestine, these may be sewn or stapled together, this is connection is called an anastomosis; or in rare instances the intestine cannot be reconnected and a stoma will been to be created, in this case one end of the intestine is brought out through an opening in the abdominal wall and will drain into a sealed pouch or drainage bag, this is called a jejunostomy or ileostomy. This stomas may be temporary to allow the intestine to heal completely, or it may be permanent. In many instances these procedures are performed in a minimally invasive fashion with laparoscopy or robotic-assisted laparoscopy..