Laparoscopic anterior resection

The operation is designed to remove part or all of the rectum. This is the bit of the bowel inside you just above your bottom muscles. It is necessary to remove so much bowel because of the way the blood supply looks after the bowel rather than because the disease is extensive. Most of the operation will be done through several very small cuts in your tummy (about 1 cm. or less each) but there will be one slightly larger cut (approximately 6 cms.) which will be made towards the end of the operation through which the excised bit of bowel will be removed.

The rectum is attached to the anal muscles which control the way you have your bowels opened. The diagrams below show the part of your large bowel, near your bottom, which will be removed during the operation. The two ends will be joined together. This is called an ANASTOMOSIS. This is a delicate procedure and it is important that you understand the possible problems you MAY encounter.

Before the operation

You will probably be admitted to hospital 1-2 days prior to your surgery. You will likely be in hospital between one to two weeks, but it may be a little longer.
A number of routine tests will be carried out to ensure you are fit for surgery. (If you have a attended a pre-admission clinic you may well have already had these tests)
You may be given some medicine to clear your bowel and you will be encouraged to drink water. This makes your bowel as clean as possible for the surgeon.
You will only be allowed to drink clear fluids and you will not be allowed to eat any solid food the day before your operation. Some people, (particularly elderly patients), require a drip before the operation to put fluid into a vein.
You will have nothing to eat for at least 6 hours prior to your surgery and will be asked to stop drinking shortly before going to theatre..
An anaesthetist will visit you and discuss your anaesthetic and various methods of post-operative pain relief.
A stoma care nurse will visit you and mark the best place on your tummy for a stoma to be formed (i.e. where a bag would be positioned) just in case this becomes necessary during the operation.

On the day of your operation.

A nurse will take you to theatre and will also collect you following your operation. After your operation you will be taken into the recovery ward, where you will have your blood pressure and pulse checked. When you are properly awake you will be taken back to the ward.
When you return to the ward from theatre you will have:

A WOUND on your tummy with stitches, sticky paper dressings or clips, covered with a dressing.
A needle into a vein (a DRIP) to give you fluids and medicines. YOU WILL NOT BE ALLOWED TO DRINK OR EAT FOR A DAY OR TWO as your bowel has had a "shock" during the operation and will not work properly at first.
A CATHETER - a small tube to keep your bladder empty.
You may have a tube in your nose (A NASO-GASTRIC TUBE) that will keep your stomach empty to stop you from feeling sick.
You may have a fine tube in your neck (A CENTRAL LINE) to help measure the amount of fluid being put into your body accurately.
You may have a DRAIN, a small tube to clear away any oozing fluids around the operation site inside. This helps to prevent infection.
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