Name of the Procedure:

Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal
Common names: Enterostomy closure, enterostomy takedown, intestinal resection and anastomosis

Summary

This procedure involves closing an enterostomy, an artificial opening created between the intestine and the abdominal wall, by surgically reconnecting the intestines and removing the bypassed segment. This helps restore normal bowel function.

Purpose

The procedure addresses conditions where an enterostomy is no longer needed, often after treatment for conditions like bowel obstructions, trauma, or disease. The goal is to restore normal intestinal continuity and function, allowing waste to pass through the natural route.

Indications

• Prior intestinal surgery requiring temporary enterostomy
• Conditions such as bowel obstructions, inflammatory bowel diseases, or traumatic injuries that required diversion
• Adequate healing and resolution of the original condition

Preparation

• Fasting for at least 8 hours before surgery
• Adjusting or stopping certain medications as advised by the doctor
• Preoperative imaging studies, like CT scans or X-rays, to evaluate the intestine
• Blood tests and other assessments to ensure the patient is medically fit for surgery

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made near the site of the enterostomy.
3. Resection: The segment of the intestine connected to the enterostomy is removed.
4. Anastomosis: The remaining healthy ends of the intestine are stitched together.
5. Closure: The enterostomy opening is closed, and the surgical incision is stitched up.

Tools: Surgical instruments, stapling devices, sutures
Anesthesia: General anesthesia

Duration

The procedure typically takes 2-4 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Surgeon specialized in gastrointestinal or colorectal surgery
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Anastomotic leakage
• Bowel obstruction
• Adverse reactions to anesthesia Management: Immediate medical intervention, antibiotics, or possibly additional surgery

Benefits

• Restoration of normal bowel function
• Improvement in quality of life
• Elimination of ostomy supplies and maintenance Expected realization: Within a few weeks post-surgery

Recovery

• Hospital stay of 5-7 days
• Gradual return to normal diet
• Avoiding heavy lifting and strenuous activities for 4-6 weeks
• Follow-up appointments for wound care and recovery monitoring

Alternatives

• Prolonged use of the enterostomy
• Revisiting the underlying condition to see if resection surgery is necessary
• Pros: Less immediate surgical risk
• Cons: Potential long-term complications of having an enterostomy

Patient Experience

During the procedure: The patient will be under general anesthesia and will not feel pain.

After the procedure:

• Pain management with medications
• Initial discomfort around the incision site
• Gradual improvement in bowel function
• Support from healthcare team for wound care and diet transition

Pain management: Medications as prescribed, comfort measures, and activity guidance to aid recovery.