diseases and disorders > laparoscopic-anterior-resection

You may have an EPIDURAL (a fine tube in your back) or PCA PUMP (a line into a vein in your arm) which gives you pain relieving medicines. PCA stands for Patient Controlled Analgesia which means you can control how much pain relief medicine is given to you through a vein using a little button switch which you can hold yourself. If you have decided not to have an epidural anaesthetic and to have PCA instead your anaesthetist will have explained how this system works before your operation.

You may have a stoma appliance (bag) on your tummy.

On return to the ward the nurses will check your blood pressure/pulse and wounds on a regular basis. This is completely normal.

It will take up to a few days to get rid of all these things (except of course a stoma), during which time the nurses will help you to wash, clean your mouth and enable you to move both in and out of bed. If you have a stoma the nurse will help you to learn how to manage the bag.
After the operation

After several days you may feel that you want to pass wind or have your bowels opened. Even if you have a stoma this is entirely NORMAL and you may pass a little old blood or mucus (slime). Please keep the nurses informed.

When you first pass stool again it will be liquid and sometimes it takes several weeks or even months to get used to your new "plumbing" arrangement. Please be patient with yourself and ask the nurses or doctors if you are worried about anything.

Occasionally some people have to adjust their dietary habits after this operation in order to keep their bowel habit regular. Please talk to one of the nurses or doctors about this if you are in doubt.
Other experiences you may have are:

A sore bottom
Constipation and/or diarrhoea
Frequent small bowel actions
A lack of control of your bowels which may mark your underclothes.
Anxiety due to the whole situation.

These are all expected occurences: please talk to one of the nurses about them as they can usually be helped with patience and further information.
It may be helpful for you to do some pelvic floor exercises. These will enable your bottom muscles to cope with the removal of your back passage. The best one to do is simply tightening up your bottom or trying to stop the flow of urine when you go to pass water.

Risks and benefits

Risks of this operation are small and much less than the risk of doing nothing but nonetheless this is a major operation and some people (less than 5%) do not survive such surgery.

There are specific risks to laparoscopic surgery (keyhole surgery) which include inadvertent accidental damage to structures inside the tummy such as blood vessels and bowel. This is very rare but if that did happen you may require an open operation with a bigger scar to put things right.
Assuming there are no such problems with your operation the benefits of laparoscopic (keyhole surgery) are such that you would have a much smaller scar on your tummy and you would make a much quicker recovery from your operation. Most people go home after this type of operation within one week.

All operations carry a risk from anaesthetics but this is minimal due to modern techniques.
Because of the nature of this particular type of surgery there is a small risk (about 5%) of injury to the bladder and the pelvic nerves that affect sexual function.

Your stoma care / specialist nurse or surgeon will discuss this further when you are asked to sign a consent form for the operation.

(published with permission in writing from:http://www.alsgbi.org)