Home Treatment Is Surgery Necessary Diverticulitis Surgeries
Diverticulitis Surgeries PDF Print E-mail

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The goal in a diverticulitis surgery is to ultimately remove the diseased section of the colon and help the patient get on with as normal life as possible.  There are various complications that are associated with diverticulitis that are in need of being treated quite aggressively.  Surgery will be advised by your surgeon at different levels and for various reasons, sometimes elective surgery to prevent any further serious attacks and other times emergency to avoid a fatal infection to spread any further.  Either way, always seek the advice of your surgeon and follow it.  If you are still nervous or unsure then quickly get a second opinion, either way diverticular disease can be very dangerous and is nothing to be ignored.

There are various levels of surgical treatment that are utilized when diverticulitis occurs.  The following is an overview of the surgeries, how they are performed, and what to expect afterwards.

Abscess Draining:
 A surgeon will drain the infection with a needle inserted through the skin by the guidance of a CT scan
  (Computed Tomography) as an attempt before surgery is considered

Primary Bowel Resection:
 This is the primary surgery used for people with diverticulitis.  The patient is put under general anesthesia,
 and the surgeon removes the diseased part of the intestine, then reconnects the healthy segments of the
colon.  How much of the colon that gets removed is usually determined during the surgery and is dependent
of how much of the bowel is damaged.  In this open surgery, there is one long incision made in the abdomen.
Fistulas will require surgical repair, which will include the removal of the length of intestine containing the origin of the fistula, followed by immediate reconnection of the two free ends of intestine, then repair of the other affected area such as the bladder, uterus, small intestine, etc..
Peritonitis will require the entire abdominal cavity to be cleaned out by an irrigation (washing) of a warmed sterile saltwater solution, and the damaged piece of intestine is removed and the healthy sections reconnected together.

Laparoscopic Partial Colectomy:                                                                                                                                      
This is an additional option to open surgery and is dependent upon the amount of inflammation and could be performed with laparoscopic surgery, which is a procedure that is done with instruments and a viewing tube are inserted through three of four tiny incisions.  The surgeon follows the images sent back via the camera in the viewing tube to perform the surgery.  The beauty of the laparoscopic procedure is that the healing and recover time is quicker; unfortunately if the inflammation is too severe, or you are a bit overweight it may not be an option. 

Bowel Resection with a Colostomy.
This surgery may become necessary if there is too much inflammation in your colon that make’s it impossible to rejoin the colon with the rectum.  Once the diseased section of colon is removed the surgeon will then make an opening known as a stoma in your abdominal wall.  The healthy part of your colon is then connected to the stoma, and the waste from your intestines will pass through the opening into a bag.  (please read our article on colostomy, it will help alleviate some of the fear of this surgery.)  This colostomy may become temporary or permanent,  generally several months after the first surgery and once the inflammation has healed, your surgeon may be able to perform the second operation necessary to reconnect your colon back to the rectum and say goodbye to the temporary bag. 

For you to have a better chance of receiving this second half of the surgery, keep in mind that the healing process is so very important for you to keep in charge of.   Listen and follow through with all your surgeons instructions, take all medications prescribed, lots and lots of rest, follow the diet recommended, don’t go back to any physical exertion too early, let others pamper you, let them make your meals, clean your house (who could fight that off), etc…  You are definitely a huge factor in your recovery so take every precaution available.
Obstructions will require immediate surgery to prevent any perforations.  Although uncontrollable bleeding is rare, if it does occur it may require removal of part or all of the large intestine.  If the entire large intestine needs to be removed a permanent colostomy will be surgically placed.

Expected Recovery

  • 4 – 7 day stay in the hospital if there are no complications, less for laparoscopic surgery.
  • When a two stage operation is done, the second stage is usually 6 – 12 weeks later.
  • The main recovery time after each surgery is 6 – 8 weeks.  (not quite a vacation, but try to enjoy it)

Statistics

  • Up to 13% of people will develop diverticulitis again after a surgery, however another surgery is generally not needed
  • Because the intestine does not always heal enough to be rejoined, 30 – 35% of two stage surgeries the colostomy can still be in place up to 4 years later.
  • The survival rate is 99% for elective surgery for diverticulitis, and emergency surgery has more risks.

If you are reading this and have not reached the surgical point in your diverticulitis yet, then good news if you have attacks and do not develop complications you might be able to avoid any surgery and control your condition with a high fiber diet. 

If you haven’t taken a wellness approach to your diverticular disease at this point, now is the time.

 
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