Laparoscopic Colon Resection Post-op Instructions

You have had surgery to remove a section of your colon, usually for a tumor or recurrent diverticulitis.

Incisions:
This was done through 4-5 small incisions that have been closed with absorbable sutures under the skin which you cannot see, and do not have to be removed. There is glue like dressing called Dermabond covering the wounds. You may shower the day after surgery, but do not submerge (in a bath, pool or ocean) for 10 days.

Diet:
The expectation is that you will stay 2-4 days after surgery and be discharged home after demonstrating some bowel function (flatus or BM). Your diet will be sequentially advanced while in the hospital. After going home, there is not a need for a special diet. There are no foods that are off limits, but I recommend eating lightly for the next week.

Pain:
Pain after this surgery is variable, depending on multiple factors, but probably most related to the amount of resection that was required. Pain is generally felt in the lower abdomen, especially around the larger incision that was used to extract the resected colon. There may be shoulder pain. The shoulder pain is referred pain from irritation of the diaphragm. There is nothing wrong with your shoulders. The pain improves quickly over the first few days after surgery. Pain while in the hospital will be controlled by IV pain medication and then oral medication. When you are discharged, if you still have pain, you will be given a prescription for pain medication to use as needed. This is usually Norco. Use this sparingly, as it can cause constipation.

Activity:
You should be up and around soon after surgery. Hopefully out of bed the same day. When you go home (a few days after surgery) it is important to walk often. You can climb stairs and be active, just avoid any significant lifting (for 6 weeks).

Issues you may have:
Constipation can occur in the post-operative period, usually due to pain medication use. I recommend using a gentle laxative like Milk of Magnesia. It is also not uncommon to have some diarrhea. this usually resolves in a few days. if not let us know. There can be blood in the first few bowel movements, and this is normal. it is only an issue if it is profuse.
Fecal urgency is common in the post-operative period in patients who have had a sigmoid colon resection, or especially a low anterior rectal resection. This manifests as a need to have frequent small BMs. This generally improves with time, as the rectum heals,. There can be a life-long change in bowel habits, though it is usually not problematic.
Call the office if you have Pain that is worsening and or associated with a fever (temperature equal or greater than 101). It is normal to have some pain, and even a low grade fever can be common. Take the pain medication, or tylenol. Be careful not to combine prescribed pain medication that contains tylenol, and OTC tylenol, or at least be sure not to take more than 4000mg in a day.