You may be suffering from diverticulitis, a condition that causes constant pain in your abdomen and fever. When your condition is difficult to control despite taking medication and other treatments, your doctor may suggest surgery. So it's normal to feel a little scared when he says that. However, once you know exactly what this operation is, how it's done, and what happens afterward, your fear will go away. Today, let's talk about this diverticulitis surgery.
Why do we need diverticulitis surgery?
Simply put, diverticulitis is the condition where small pouches (diverticula) form in the walls of our colon, which we medically call diverticula , become infected or inflamed. It is only when this condition becomes severe that surgery is considered.
Your doctor will usually recommend surgery in the following cases:
- If the condition cannot be controlled despite taking medication and other non-surgical treatments.
- If this condition recurs after treatment (recurrent diverticulitis).
- An abnormal connection, such as a fistula , forms between the wall of the large intestine and nearby organs such as the bladder or vagina.
This surgery essentially involves cutting out and removing a portion of the large intestine that is affected by the disease. We call this a partial colectomy .
Most often, the sigmoid colon, the last part of the large intestine, is removed. When this part is removed, the symptoms almost completely disappear.
Sometimes, after removing part of this intestine, the surgeon also has to perform an ostomy . Let's take a look at what that is.
What types of surgeries are these?
Your surgeon may choose one of these surgeries depending on your condition.
| Type of surgery | A simple explanation |
|---|---|
| Open Colectomy | In this, the doctor makes a large vertical incision in your abdomen, removes the diseased part of your intestine, and reconnects the two healthy parts. This is a traditional procedure. |
| Laparoscopic/Robotic Colectomy | It's what we call "key-hole surgery." It's done by making a few small incisions in the abdomen and inserting a camera (laparoscope) and delicate instruments. It's less painful, and the wounds heal faster. |
| Ostomy surgery | This is done when a section of the intestine has been removed and the remaining healthy parts cannot be connected at once. This involves creating a temporary opening in the skin of the abdomen for stool to pass through. |
A little more information about Ostomy surgery
Don't be afraid when you hear this. Think of it like building a road, temporarily creating another road for vehicles to pass through. Something similar is happening here. This temporary road is being built to stop feces from passing through the area where the intestinal surgery was performed until it heals.
- Colostomy: A part of the large intestine is connected to the skin of the abdomen, creating an opening. Stool comes out through it and collects in a pouch (colostomy bag) that is attached to the abdomen.
- Ileostomy: This opening is created using a portion of the small intestine (ileum).
The important thing is that these ostomy surgeries are often temporary . In a few months, after the internal wounds have healed, another minor surgery can be performed to close the opening and restore normal bowel movement.
How do you prepare before surgery?
You will need to make some preparations before the operation. Your doctor will give you clear instructions about this. Usually, these things happen.
- Additional scans: You may be asked to have a computed tomography (CT) scan or other special X-ray tests.
- Health check-up: You may need to have blood tests, a colonoscopy , an EKG , etc. You may also meet with the anesthesia team.
- Bowel Prep: This is the hardest part. You will be asked to stop eating for a few hours before the surgery and only drink liquids like water and soup. You will also be given a special medicine to completely cleanse your intestines.
What happens during the surgery?
For all of these surgeries, you are completely anesthetized (general anesthesia), which means you don't feel anything, you are asleep.
1. The doctor makes one large incision in open surgery, or several small incisions in laparoscopic surgery to reach the large intestine.
2. Then the diseased part of the intestine with diverticulitis is removed .
3. The two healthy parts of the intestine are reconnected using staples or sutures.
4. If necessary, an ostomy is performed to connect a portion of the intestine to the skin.
5. Finally, the incisions made in the abdomen are closed.
This surgery usually takes about three to four hours , but this time can vary depending on your condition and the type of surgery being performed.
What happens after the surgery? And how long does it take to recover?
You will need to stay in the hospital for a few days after the surgery. This will depend on how quickly you recover. During this time:
- Food and Drink: For the first few weeks, you will need to eat low-fiber, light, liquid foods like porridge and soup. After about a month, you can eat anything you normally like.
- Exercise and weight lifting: You should avoid lifting weights for 6-8 weeks .
- Driving: You will be able to drive a vehicle only after you stop taking painkillers.
- Wound care: The nursing staff will teach you how to care for your wound. If you have an ostomy, they will also teach you how to use the bag.
It can take several months to fully recover. It is very important to be patient.
Are there any risks to this surgery?
As with any surgery, there are some risks. Anastomotic leak, bleeding, or wound infection can occur. However, these are very rare. This surgery is very successful , and about 98% of patients do not develop diverticulitis again.
When to see your doctor again
If you experience any of these symptoms after returning home from surgery, you should call your doctor immediately :
- Severe stomach pain that doesn't subside even after taking medication and is getting worse.
- Inability to pass stool.
- Signs of infection, such as swelling, redness, fever, or vomiting around the wound.
Take-Home Message
- Diverticulitis surgery is a highly effective treatment for severe, recurring conditions that cannot be controlled with medication.
- There are two main types of surgery: open and laparoscopic (key-hole). Your doctor will decide which is best for you.
- Sometimes a temporary opening (ostomy) can be created to allow stool to pass through. This is usually temporary, so don't worry.
- It takes several months to fully recover from surgery. During this time, it is very important to follow the doctor's instructions exactly.
- Talk openly with your doctor about any questions or fears you may have before the surgery.
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