DefinitionThis is surgery of the abdominal wall and intestines. An opening is made into the intestines to drain the contents out or put in a feeding tube.
|The Stomach and Intestinal Tract|
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Reasons for ProcedureThis surgery is done when a new exit for intestinal or fecal matter is needed. It may be needed when feces can no longer travel through the bowels and out the anus.An enterostomy may also be needed when food can no longer enter the mouth or stomach normally. In this case, a feeding tube will be placed to help food enter the intestines.
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Blood clots
- Skin irritation around the stoma from leaking digestive fluids
- Intestinal obstruction
- Hernia the at surgical site
- Blockage or leakage of the tube, requiring replacement
- Adverse reaction to the anesthesia
What to Expect
Prior to Procedure
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Your intestines will be cleaned with a special solution.
- Your doctor will talk to you about the physical and emotional difficulties that you will face after this surgery.
AnesthesiaGeneral anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
Description of the ProcedureThere are different ways this surgery can be done. In one technique, an intestinal sac for collecting fecal waste is created inside of the abdomen. This sac will include a hole called a stoma in the abdominal wall. The stoma allows access to the sac so that it can be emptied through a tube. In another technique, the intestine is directly attached to the abdominal wall so that an external bag can be attached to collect fecal waste.If the surgery is done to place a feeding tube, an incision will be made in your abdominal wall. The doctor will grasp a section of your small intestine. A small opening will be made. The tube will be placed through this opening and secured in place with sutures. The tube will then be brought through your abdominal wall. It will be secured with sutures.These procedures may be done by an:
- Open procedure, which uses an abdominal incision
- Laparoscopic procedure, which uses several small incisions
How Long Will It Take?
- 30-45 minutes to insert the tube
- 2-4 hours if sections of the intestine need to be removed
How Much Will It Hurt?Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital StayThis procedure is done in a hospital setting. The usual length of stay is 2-4 days. Your doctor may choose to keep you longer if complications occur.
Post-procedure CareAt the Hospital
- You may need antibiotics. You may also need medicine for nausea and pain.
- If you had an enterostomy to help fecal matter exit the bowels, you may have a pouch on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
- The staff will monitor your fluid intake and output to help you avoid dehydration.
- You will wear boots or special socks to help prevent blood clots.
- You will be asked to walk often after surgery.
- You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.
- Your incision will be examined often for signs of infection.
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
- You will need to practice good skin care of the area around the stoma. This will help to prevent infection.
- You will need to rest for 1-2 months.
- You will be taught how to care for the stoma site and change the ostomy bag if you have one.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
Call Your DoctorCall your doctor if any of these occur:
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the stoma site
- Pus or yellow/green discharge from the incision
- Persistent nausea and/or vomiting
- Signs of infection, including fever and chills
- Severe abdominal pain
- Cough, shortness of breath, or chest pain
- Pain and/or swelling in your feet, calves, or legs
- Pain, burning, urgency, frequency of urination, or blood in the urine
- Blood in your stool, or black, tarry stools
- If you had a feeding tube placed, food cannot pass through the tube
- The tube comes out or leaks
- If you had an ostomy bag placed, and there is no stool collecting in the bag.
Family Doctor—American Academy of Family Physicians
National Digestive Diseases Information Clearinghouse
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Shellito PC, Malt RA. Tube gastrostomy. Techniques and complications. Ann Surg. 1985;201:180-185.
Torosian MH, Rombeau JL. Feeding by tube enterostomy. Surg Gynecol Obstet. 1980;150:918-927.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Daus Mahnke, MD
- Review Date: 01/2015
- Update Date: 05/07/2014