Name of the Procedure:

Reduction of volvulus, intussusception, internal hernia by laparotomy

• Also known as: Open Reduction of Bowel Obstruction

Summary

This surgical procedure involves making an incision in the abdomen (laparotomy) to correct complications such as a twisted bowel (volvulus), a telescoping bowel segment (intussusception), or an internal hernia. The aim is to restore normal bowel function by untangling or removing the obstruction.

Purpose

• Medical Condition: Treats life-threatening bowel obstructions caused by volvulus, intussusception, or internal hernias.
• Goals: Ensure the bowel is restored to its normal position, preserve bowel tissue, and prevent complications like bowel ischemia or perforation.

Indications

• Severe abdominal pain
• Bloating and distension
• Vomiting
• Not passing stools or gas
• Criteria: Suspected or diagnosed volvulus, intussusception, or internal hernia via imaging or clinical evaluation.

Preparation

• Fasting: Typically, no food or drink for 8 hours before surgery.
• Medications: Adjustments as advised by the healthcare provider.
• Tests: Blood tests, imaging studies (e.g., CT scan, ultrasound).

Procedure Description

1. Incision: A surgical incision is made in the abdomen.
2. Exploration: The surgeon examines the abdominal organs to locate the obstruction.
3. Reduction: The bowel is untwisted and any obstructions are cleared.
4. Repair: Damaged sections of the bowel may be repaired or removed.
5. Closure: The surgical site is closed with sutures or staples.
   • Tools: Scalpels, retractors, suture materials.
   • Anesthesia: General anesthesia to ensure the patient is unconscious and pain-free.

Duration

The procedure typically takes 1-3 hours, depending on the complexity of the obstruction.

Setting

Performed in a hospital operating room equipped for major surgeries.

Personnel

• Surgeons
• Surgical Nurses
• Anesthesiologists
• Surgical Technicians

Risks and Complications

• Common Risks: Infection, bleeding, injury to surrounding organs.
• Rare Risks: Blood clots, respiratory complications, prolonged ileus (temporary bowel paralysis).
• Management: Close monitoring and immediate management of any arising complications.

Benefits

• Restored Bowel Function: Immediate relief from obstruction symptoms.
• Pain Relief: Substantial reduction in abdominal pain post-procedure.
• Prevention: Avoidance of severe complications like bowel perforation and sepsis.

Recovery

• Post-Procedure Care: Pain management, antibiotics, gradual reintroduction of diet.
• Recovery Time: Typically 4-6 weeks; full recovery may take longer.
• Restrictions: Limited physical activity, no heavy lifting; follow-up appointments for wound and condition assessment.

Alternatives

• Less Invasive Methods: Endoscopic reduction for some cases.
• Non-Surgical Options: May include bowel rest and nasogastric decompression.
• Pros and Cons: Alternatives may be less invasive but could be less effective or not applicable for severe cases.

Patient Experience

• During Procedure: Under general anesthesia; no awareness or pain.
• After Procedure: Possible pain and discomfort managed with medication; gradual return to normal activities.
• Pain Management: Standard post-operative pain management protocols to enhance comfort.