How bowel surgery is done

There are a few ways of doing bowel surgery. These include:

• Open surgery. This is the traditional method. It's done through one large cut (incision) in the belly. This cut is large enough for the surgeon to have a direct view of the bowel.

• Laparoscopic surgery (laparoscopy). This is done through several smaller cuts in the belly. A thin tube with a tiny video camera and a light attached is put through one cut. This gives the surgeon a clear view of the inside of the belly. Surgical tools are then put through other small cuts to do the surgery.

• Robotic surgery. This is similar to laparoscopic surgery except that it is done using very small tools attached to a robotic arm. The surgeon sits at a computer and directs the movements of the robot.

Sometimes the surgeon has to switch from a laparoscopic surgery to an open surgery during the procedure. This is for the health of the child.

Getting ready a few weeks before surgery

Talk with your child’s doctor about any medicines your child takes. This includes over-the-counter medicines, herbs, and supplements. Your child may have to avoid taking certain kinds of medicines before the surgery. This will help prevent problems during the surgery. Also tell your child's doctor about any allergies your child has.

Getting ready the day before surgery

Follow any directions your child is given for taking medicines and for not eating or drinking before surgery. This includes any instructions you are given for bowel prep. You may be asked to wash your child with a special type of antibacterial soap before coming to the hospital. This is to help reduce the chance for infection.

The day of surgery

Here is what to expect on the day of surgery:

• Arrive at the hospital on time. You will need to fill out certain forms.

• Your child will change into a gown.

• An anesthesiologist or nurse anesthetist will meet with you. They will discuss the medicines that will help your child sleep through the surgery. Be sure to ask any questions you have. 

• Your child will be given an IV (intravenous) line. This gives your child fluids and medicines. Depending on the age of your child, the IV line may be put into the arm or the hand. The IV may be started after your child is asleep.

During the surgery

Here is what to expect during the surgery:

• Your child will be given general anesthesia. This puts your child into a deep sleep. A breathing tube will be placed in the trachea (windpipe) to help your child breathe during the surgery.

• A soft tube (catheter) may be placed into your child’s bladder. This helps drain urine.

Recovering in the hospital

Here is what to expect while your child is recovering in the hospital: 

• After the surgery, your child will be taken to the recovery room. This is also called the post-anesthesia care unit, or PACU. Later, your child may be moved to a regular hospital room.

• Your child will be attached to monitors that check breathing, blood pressure, and pulse.

• Your child will be given pain medicine to stay comfortable.

• The catheter used to drain urine will likely be removed soon after surgery. The IV line will stay in place for a few days.

• Your child may be asked to get up and walk around soon after surgery. This helps improve blood flow and prevent blood clots. It also helps the colon return to normal function (if the colon was not removed) and to prevent a bowel blockage.

• Your child may not eat or drink anything until the colon (if not removed) starts working again. But often they can start eating or drinking by the next day. Your child may start with a liquid diet and slowly add more foods as prescribed.

• Your child may have been given an opening in the belly (stoma) during the surgery. If so, stoma care will be discussed with you.

• Your child may need to stay in the hospital for several days or longer. How long depends on the procedure and their condition.

Recovering at home

Here is what to expect while your child is recovering at home: 

• Bring your child back to the doctor for follow-up as scheduled after surgery.

• Your child may walk as much as is comfortable. Being active helps the body heal. But too much activity can harm the healing incision(s). Your child should not lift heavy things or do vigorous activity, such as running and sports, until the doctor says it's okay.

• Your child may have some bloating, loose stools, and more frequent bowel movements. This is normal after bowel surgery.

• Give your child any prescribed or over-the-counter medicines as instructed.

• Follow any other instructions you are given for recovery.

When to contact the doctor

Contact your child's doctor right away if:

• Your child has a fever greater than 101°F (38.3°C) that does not go away. Always follow your doctor's instructions on fever and when to contact them.

  • Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

  • For babies and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method.

  • Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

  • When you talk to your child’s doctor, tell them which method you used to take your child’s temperature.

• Your child has nausea or is vomiting.

• There is increasing redness, swelling, discharge, or pain around an incision.

• Your child has trouble passing stool.

• There is blood in your child's stool.

• Your child has belly swelling or pain that gets worse or doesn't go away.

• Your child is losing weight.

• There is swelling in your child's legs.

• Your child has trouble breathing.