What to expect during bowel cancer surgery

Preparing for bowel cancer surgery

To prepare for bowel cancer surgery, a cancer surgeon will ask questions about medical history and a physical examination will be carried out.

There will be time to ask about the procedure and what happens afterwards.

Specific instructions will be given, but patients may be asked to follow a special diet a day or 2 before the operation, or to take a laxative for a few days beforehand. In some hospitals, patients are given an enema before the procedure.

All patients are generally asked to provide a blood sample.

• Depending on age and general health additional tests may be done, including:
• ECG ( electrocardiogram)
• Chest X-ray
• Lung function tests.

You will see an anaesthetist, who will discuss the type of anaesthetic you will be given during the surgery, and you will also learn about pain control after the operation.

You will not be able to have anything to eat or drink for 6-8 hours before the operation.

The day of your surgery

An intravenous (IV) tube will be inserted into a vein in your arm to deliver drugs and fluids.

Once the surgeon is ready for you, you will be taken to the operating theatre.

When you arrive in the operating theatre, the nurses will help you on to the operating table. The anaesthetist will inject a drug into your IV tube that will put you to sleep. After you are asleep, the nurses will clean your abdomen with an antibacterial preparation and cover you with sterile drapes.

If you are having open surgery, the surgeon will make an incision in the abdomen. Cancerous tissue and some normal colon on either side of the cancer will be removed, as well as the nearby lymph nodes.

Open surgery is the most common surgery for bowel cancer. After this, you can expect to be in hospital for an average of 8-10 days.

In some cases laparoscopic 'keyhole' surgery may be possible. The stay in hospital is usually around 3-4 days. Tiny incisions are made for the laparoscope - a thin tubular device with a camera on the end. Carbon dioxide gas is pumped into the abdominal cavity to inflate the area and make surgery easier. Images from inside the body are viewed on a video monitor. Other surgical instruments will be passed through additional incisions.

Final checks will be made to make sure it is safe for the operation to begin.

Your surgeon will begin the main intestinal surgery by closing the larger blood vessels serving the diseased section of the small or large intestine. Next, they will separate the fatty tissue that holds the intestine in place. Once the diseased section of intestine is freed from its supporting structures, it can be removed.

Where possible the surgeon will reconnect the two ends of intestines. However, a temporary or permanent stoma waste tube may be required.

Finally, they will check for any bleeding, rinse out the abdominal cavity, release the gas from the abdomen and close the incisions.