Surgery of the Small Intestine

Many conditions can necessitate an operation

Many different types of conditions can bring the need for surgery of the small intestine.  These include conditions that cause infections, inflammations, ulcers, or obstructions (due to blockages or deformations) in this portion of the digestive tract. 

Surgery is often aimed at removing compromised sections of the small intestine and rejoining its healthy sections by reconnecting the resected ends.  Conditions that can cause disruptions of small bowel function include inflammatory bowel disease, acid disease, peptic ulcers, bile duct conditions, bacteria and other infectious agents, diverticular disease, cancer, and other intestinal problems.  Diagnosis may include CT and a variety of gastroenterology tests, including videocapsule endoscopy, a non-intrusive procedure in which the patient swallows a miniature camera about the size of a vitamin pill that takes and transmits images of the intestine as it travels the gastrointestinal track and is eventually expelled.  This procedure can give the team specific information on locations of conditions in the small intestine. Specialists in Aria's Division of Gastrointestinal Disease are experienced in offering such testing and evaluation, and in assisting the team in seeking conservative, noninvasive means of treating these conditions.

If such treatment is not an option or not successful, though, surgeons can remove or repair a section of small intestine either through a traditional open operation or laparoscopically.   In the latter case, instead of making one large incision in the abdomen, the team makes several small incisions and uses a fiberoptic scope to visualize the intestine on a video screen, as it inserts other instruments to manipulate and resect the intestine.

Even when performed laparoscopically, however, intestinal resection is a significant operation.  It requires general anesthesia, a stay in this hospital of at least several days, and recuperation (including bed rest at home) afterwards.  Intestinal function normally recovers after several weeks.  Recovery is typically faster after laparoscopic surgery.

If the repaired portion of the bowel is distant from the stomach and needs to be spared its digestive work while healing, the surgeon may create an opening to the surface of the abdomen (stoma) through which the healthy end of the small intestine (coming from the stomach) can exit and deliver liquid feces into a drainage back.   This ileostomy arrangement is temporary (unless the large bowel has also been removed).  The surgeon will close the stoma and reconnect the ends of the small intestine in a subsequent operation.

These operations are well established and usually very safe.  They are one of the most common reasons for major abdominal surgery.