What is perianal fistula surgery?

Most anal fistulas are the result of an infection that begins in the anal gland. The fistula forms a tunnel under the skin and connects to the infected gland. Surgery is usually necessary to treat a perianal fistula.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or general practitioner must inform the attitude to be followed.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for perianal fistula surgery, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Perianal fistula surgery can be performed under general or spinal anesthesia. Numbing medications will be given intravenously in your arm or through a catheter in your spine. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe if your case ultimately benefits from a general anesthetic. Your surgeon will then perform the surgery.

DURING THE PROCEDURE

Your doctor might recommend one of the following treatments:

• Removal of the perianal fistula (fistulectomy). Among one of the techniques that he can choose, the surgeon removes all the tissue that forms the fistula. Sometimes, removing the entire length of the fistula involves cutting the anal sphincter muscle, which is responsible for controlling gas and faeces leaks.
• Opening and cleaning of the perianal fistula (fistulotomy). The surgeon locates the tissue that forms the fistula, opens it, and cleans it. This option is less aggressive but with a greater possibility of reappearing the fistula.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 6 hours, you will begin with the intake of liquids and then solid foods. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised at all times by nursing staff.

If your surgery was performed in the morning and you have no previous illnesses, you may be discharged at the end of the day. If your surgery took place in the afternoon, you will usually leave the following noon.

HOW IS THE RECOVERY AT HOME?

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. It is essential to inform the patient that anal pain will be present during the first two weeks after surgery, so we will prescribe painkillers to control it. Sometimes you may need heparin injection to prevent the appearance of thrombi in your legs.

In relation to food, we recommend a diet rich in fiber (vegetables, salads, fruit…) together with an abundant intake of water to ensure that your stools are of a soft consistency and produce the least anal pain when defecating. You may need fiber or laxatives if you have significant constipation after the intervention.

We will recommend sitz baths with warm water and neutral soap several times a day and after defecation. This will ease your discomfort. Avoid using toilet paper. You will be periodically evaluated by nursing staff on an outpatient basis.

Walk every day and as you feel less pain, increase the time you dedicate to it. Avoid physical exertion until the surgeon assesses you.

Virtually full recovery can take approximately three to six weeks after surgery, depending on the characteristics of your fistula.

What are the risks of perianal fistula surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and frequent risks: Infection or bleeding from the wound, acute retention of urine, inflammation of the anus. Prolonged pain in the area of ​​the operation. Phlebitis

Infrequent and serious risks: Significant infection of the anus and perineum. Incontinence to gases and even feces. Anus stenosis. Reproduction of the fistula.

These complications are usually resolved with medical treatment (medications, serums, etc.), but they may require a reoperation, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having fistula surgery.

What is pilonidal sinus surgery?

The sinus or pilonidal cyst is an abnormal cavity in the skin that usually contains hair and skin fragments. In most cases, it is located near the coccyx, in the upper part of the groove between the two buttocks. The sinus can be drained through a small incision when superinfected or surgically removed as definitive treatment.

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or general practitioner must inform the attitude to be followed.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for pilonidal sinus surgery, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Perianal fistula surgery can be performed under local anesthesia and sedation, general anesthesia, or spinal anesthesia. Numbing medications will be given intravenously in your arm or through a catheter in your spine. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe if your case ultimately benefits from a general anesthetic. Your surgeon will then perform the surgery.

DURING THE PROCEDURE

Your doctor might recommend one of the following treatments:

• Surgical drainage. When your sinus has an infection and does not respond to antibiotic treatment, it will be indicated to make an incision over the cyst under local anesthesia. This will allow the pus that has been produced inside to be evacuated but will not eliminate the cyst. In the future, a definitive surgery will have to be performed.
• Removal. The surgeon locates the tissue that forms the cyst and proceeds to its removal. This option is more aggressive but manages to eliminate it permanently. Sometimes skin closure can be performed if the conditions of the tissues and the size of the cyst allow it. In others, this closure will not be performed and the patient will require nursing care for weeks to achieve closure of the defect through healing from the depths to the surface.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 6 hours, you will begin with the intake of liquids and then solid foods. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised at all times by nursing staff.

If your surgery was performed in the morning and you have no previous illnesses, you may be discharged at the end of the day. If your surgery took place in the afternoon, you will usually leave the following noon.

HOW IS THE RECOVERY AT HOME?

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. It is essential to inform the patient that the pain in the intergluteal area will be present during the first two weeks after surgery, so we will prescribe painkillers to control it. Sometimes you may need heparin injection to prevent the appearance of thrombi in your legs.

In relation to food, we recommend a soft diet in the first week to later resume your usual diet.

If finally the skin closure has not been performed, you will be evaluated daily by nursing on an outpatient basis. They will heal you and apply the appropriate treatment at each stage to help you heal.

Walk every day and as you feel less pain, increase the time you dedicate to it. Avoid physical exertion until the surgeon assesses you.

Virtually full recovery can take approximately three to four weeks after surgery, if skin closure has been performed. If the defect remains open, healing can take between 4 and 12 weeks, depending on the characteristics of your sinus.

What are the risks of pilonidal cyst surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Less serious and frequent risks: Infection or bleeding of the wound, acute retention of urine. Prolonged pain in the area of ​​the operation.

Infrequent risks: Reproduction of the sinus.

These complications are usually resolved with medical treatment (medications, serums, etc.), but they may require a reoperation, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having fistula surgery.

What is rectal surgery?

Rectal surgery is a surgical procedure in which all or part of the rectum is removed. The rectum is a long tube-shaped organ at the end of the digestive tract and is attached to the anus.

Rectal surgery often requires other procedures to reconnect the remaining parts of the digestive system and allow waste to pass out of the body.

Rectal surgery is used to treat and prevent diseases and disorders that affect the rectum, such as:

• Rectal cancer. Early-stage rectal cancer may require removal of only part of the rectum. More advanced cancer may require removal of the entire rectum and neighboring organs such as the urinary bladder, prostate, and uterus.
• Inflammatory bowel disease (Crohn’s disease or ulcerative colitis). If medications don’t help, removal of the affected part of the rectum may offer a resolution of your signs and symptoms.
• Uncontrollable bleeding. Heavy bleeding from the rectum may require surgery to remove the affected part of the rectum, although it can usually be controlled by colonoscopy or with the help of vascular radiology.
• Intestinal obstruction. A blocked rectum is an emergency that may require a rectal resection, depending on the situation. Usually an opening of the colon is made prior to the obstruction to the abdominal wall.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

Normally you must be evaluated by Hematology before the intervention since they must draw blood to study your blood group and make a reserve of blood bags for the day of the intervention. In this surgery, bleeding is an important complication, so we must offer you maximum safety. For your peace of mind, most of our patients do not require a blood transfusion.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a cholecystectomy, your surgeon may ask you to:

• Do not eat anything before surgery.  You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.
• Drink a solution to cleanse the intestine.  Your doctor may prescribe a laxative solution to mix with water at home. Drink the solution over a period of several hours, as directed. The solution causes diarrhea to help you empty your colon. Your doctor may also recommend that you take enemas.

It is not always possible to prepare for a rectal resection. For example, if you need emergency rectal surgery for a bowel obstruction or perforation, you may not have time to prepare.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A resection of the rectum is performed under general anesthesia, so you will not be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe, place a catheter to monitor your urine, put a tube into your stomach through your nose, and put IVs in your neck and wrist. to administer drugs and know your heart function.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

• Open rectal resection. In open surgery, a longer incision is made in the abdomen to access the rectum. The surgeon uses surgical tools to free the rectum from surrounding tissue and cuts out a part of the rectum or the entire rectum.
• Laparoscopic resection of the rectum. In laparoscopic resection, also called minimally invasive surgery, several small incisions are made in the abdomen. The surgeon inserts a tiny video camera through one incision and certain special surgical tools through the other incisions.

The surgeon watches a video screen in the operating room as tools are used to free the colon from surrounding tissue. The rectum is then removed through a small incision in the abdomen.

Laparoscopic surgery relieves pain and reduces recovery time after surgery. But not everyone is a candidate for this procedure. Also, in some situations, the operation may begin as a laparoscopic resection of the rectum, but circumstances may require the surgical team to convert it to open surgery.

Operations used to treat rectal cancer include the following:

• Remove very small cancers from inside the rectum. Very small rectal cancers may be removed using a colonoscope or other type of specialized endoscope inserted through the anus (transanal local excision). Surgical tools may be passed to remove the cancer and some of the healthy tissue around it.

This procedure may be an option if your cancer is small and unlikely to spread to nearby lymph nodes. If laboratory tests determine that the cancer cells are aggressive or more likely to spread to the lymph nodes, your surgeon may recommend additional surgery.

• Remove all or part of the rectum. Larger rectal cancers that are far enough from the anal canal may be removed in a procedure (low anterior resection) that removes all or part of the rectum. Nearby tissue and lymph nodes are also removed. This procedure preserves the anus so that waste can pass out of the body normally.

How the procedure is done depends on the location of the cancer. If the cancer affects the upper part of the rectum, that part of the rectum is removed and then the colon is connected to the rest of the rectum (colorectal anastomosis). The entire rectum may be removed if the cancer is located in the lower part. The colon, shaped like a bag, joins the anus (coloanal anastomosis).

• Remove the rectum and anus. For rectal cancers located near the anus, it may not be possible to completely remove the cancer without damaging the muscles that control bowel movements. In these situations, surgeons may recommend an operation called an abdominoperineal resection to remove the rectum, anus, and part of the colon, as well as nearby tissues and lymph nodes.

The surgeon creates an opening in the abdomen and joins the remaining colon (colostomy). Waste leaves your body through the opening and collects in a bag that attaches to your abdomen.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the node was. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. You will be for a short period of time in an area called post-anesthetic recovery or Intensive Care Unit for greater surveillance if your situation requires it. You will then be transferred to your room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 24 hours, you will begin with the intake of liquids and then solid foods in the following days. We recommend sitting down and starting to walk about 24 hours after the intervention. The catheter that is inserted into your bladder will be removed in 1 or 2 days. At all times you will be supervised and helped by nursing staff.

If the surgeon has finally performed a stoma, you and your companion will receive the necessary information and training for its management.

If your surgery progresses on the ward without any incident, you will remain hospitalized for around 7 days.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend a soft diet for the first week and avoid copious meals. Subsequently, all types of food will be progressively reintroduced, being fundamental those rich in fiber such as vegetables and fruit. You must be well hydrated so we recommend that you drink at least 1.5 liters of non-carbonated liquids. Occasionally diarrhea may appear that usually lasts a few days or a week in relation to the new situation of the digestive system.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

If you have had an opening from the intestine to your abdominal wall, we will facilitate contact with a specialized nurse (stomatherapist) in the management of the stoma who will help you and resolve all kinds of doubts.

Virtually full recovery can take approximately three to four weeks for laparoscopic colectomy. However, with open colectomy, once at home, full recovery can take four to six weeks. It will depend on your physical condition before surgery and the complexity of the operation.

What are the risks of rectal resection?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and frequent risks: Infection or bleeding from the wound, acute urinary retention, phlebitis, increased number of bowel movements. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Fistula of the anastomosis due to impaired healing that in most cases is resolved with medical treatment (medicines, serums, etc.), but that sometimes requires intervention with the creation of an artificial anus. Intra-abdominal bleeding or infection. Intestinal obstruction. Sexual dysfunctions that can lead to impotence. Altered continence to gases and even feces. Reproduction of the disease. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having a rectal resection.

What is skin and soft tissue surgery?

Skin and soft tissue surgery is also known as “minor surgery.” It is a surgical intervention to remove lesions in the skin or in the fatty tissue that is under it. These lesions include moles, warts, lipomas, sebaceous cysts or malignant tumors. It is a common surgery and carries a small risk of complications. In most cases, local anesthesia is used and you can return home after the intervention.

Previous considerations

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for minor surgery, your surgeon may ask you to do the following:

• Do not eat large meals before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Skin and soft tissue surgery is usually performed under local anesthesia. In exceptions, we can use intravenous drugs (sedation) to make you more comfortable during the procedure.

DURING THE PROCEDURE

The surgeon makes an incision, proceeds to remove the lesion and then the wound is sutured. This intervention will not last more than thirty minutes.

What happens after the surgery?

After surgery, the patient will go home. We recommend not driving for the home transfer.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally, the taking of painkillers is indicated to control the pain.

In relation to food, we recommend your usual diet.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Almost total recovery can take approximately one to two weeks after the intervention

What are the risks of skin and soft tissue surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Less serious and frequent risks: Infection, bleeding or alteration in the healing of the surgical wound. Dehiscence (opening) of the wound. Prolonged pain in the area of ​​the operation. Local allergic reactions to the anesthetic, such as itching or redness around the lesion.

Infrequent and serious risks: Serious allergic reactions to the anesthetic, including anaphylactic shock.

Infrequent risks: Reproduction of the lesion.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having this surgery.

What is a skin lesion?

Among the most frequent skin lesions are soft fibromas, moles, etc. Most of these injuries are harmless. In rare cases, they become cancerous. Controlling moles and other pigmented spots is an important step in detecting skin cancer, especially malignant melanoma. The medical term for moles is “nevus.”

What symptoms does it cause?

Most of these injuries do not produce symptoms. Sometimes, depending on their location, they can cause some discomfort secondary to rubbing against clothing. The typical mole is a brown spot. However, moles can come in different colors, shapes, and sizes.

Rare moles that may indicate the presence of melanoma

The following “ABCDE” guide can help you determine if a mole or blemish may be melanoma or other types of skin cancer:

• The letter “A” represents asymmetry. One half is different from the other.
• The letter “B” represents the edge. Look for moles that have ragged edges, cuts, or waves.
• The letter “C” stands for color. Look for growths that have changed color, are many colors, or are irregular in color.
• The letter “D” represents the diameter. Look for new growths on moles that are larger than 1/4 inch (about 6 millimeters).
• The letter “E” represents evolution. Watch for moles that change in size, shape, color, or height, especially if part or all of a mole turns black. Moles can also evolve and produce new signs and symptoms, such as itching or bleeding.

Cancerous (malignant) moles vary greatly in appearance. Some may have all of the above features. Others may only submit one or two.

How is it diagnosed?

Your doctor can identify the different skin lesions by performing a physical exam. If the doctor suspects that a skin lesion may be cancerous or causes you discomfort due to its location, I can indicate surgery.

What treatment options exist?

Most skin lesions do not need treatment. If removal is indicated, it is a quick and usually outpatient procedure. The doctor uses a local anesthetic and removes the lesion with a margin of healthy skin if necessary. The procedure could leave a permanent scar.

What is small intestine surgery?

The small intestine runs from the stomach to the large intestine (colon). We can differentiate has three sections: the duodenum, the jejunum and the ileum.

Small intestine surgery consists of removing a part of it and then proceeding to join it so that the food can continue its journey from the stomach to the colon. The small intestine is responsible for digesting and absorbing nutrients from the food you eat. It produces hormones that aid digestion. The small intestine also plays a role in the body’s immune system that fights germs.

The most common reason for small intestine surgery is the presence of tumors, with benign characteristics on some occasions but mostly cancerous (malignant) lesions. 

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for small bowel surgery, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Small bowel surgery is performed under general anesthesia, so you won’t be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe. Your surgeon will perform intestinal surgery using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) bowel resection

During a laparoscopic bowel resection, the surgeon makes four or five small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the diseased segment of small intestine and subsequently restore intestinal continuity. This intervention takes two or three hours.

A laparoscopic resection is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) bowel resection

During open bowel surgery, the surgeon makes a 6- to 8-inch incision in the center of your abdomen. Muscle and tissue are retracted to reveal the small intestine. The surgeon then removes the segment of small intestine and reattaches it.

The incision is sutured and you are taken to a recovery area. An open bowel surgery takes about two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the surgery was performed. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 24 hours, you will begin with the intake of liquids and in the following days solid foods. We recommend sitting down and starting to walk about 12 hours after the intervention. You will be supervised at all times by nursing staff.

It will usually go away between three to five days after the intervention.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend avoiding copious meals during the first week. Subsequently, all types of food will be progressively reintroduced, with possible intolerance of some of them, so their intake will be suspended and they will be tried again in the following weeks. Occasionally diarrhea may appear that usually lasts a few days or a week in relation to the new situation of the digestive system.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery can take approximately two to three weeks in laparoscopic surgery. However, with open bowel resection, once at home, full recovery may take three to five weeks.

What are the risks of small intestine surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and frequent risks: Infection or bleeding of the wound, acute retention of urine, phlebitis. Delay in the restoration of normal intestinal transit, which will require treatment with serums. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Dehiscence of the laparotomy (opening of the wound). Fistula of the anastomosis due to alteration in the healing of the suture. Intra-abdominal bleeding or infection. Intestinal obstruction. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reintervention, generally urgent, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having small intestine surgery.

What is splenectomy?

Splenectomy is a surgical procedure to remove the spleen. The spleen is an organ that sits below the rib cage on the upper left side of the abdomen. It helps fight infection and filters out unnecessary materials, such as old and damaged cells from the blood.

The most common reason for a splenectomy is to treat a ruptured spleen, which is often the result of trauma. Splenectomy may be done to treat other conditions, such as an enlarged spleen causing discomfort (splenomegaly), some blood disorders, some cancers, infections, and noncancerous cysts or tumors.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

Before the intervention, your doctor will recommend that you be vaccinated against different bacteria and viruses, since by removing the spleen your body will have a greater risk of contracting infections from these germs.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a splenectomy, your surgeon may ask you to do the following:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A splenectomy is performed under general anesthesia, so you won’t be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe. Your surgeon will perform the splenectomy using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) splenectomy

During a laparoscopic splenectomy, the surgeon makes four small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the spleen through an incision that is several inches long.

The incisions are then sutured and you are moved to a recovery area. A laparoscopic splenectomy takes two to three hours.

A laparoscopic splenectomy is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) splenectomy.

During an open splenectomy, the surgeon makes a 6- to 8-inch incision in the abdomen below the ribs on the left side. The muscle and tissue are retracted to reveal the spleen, which will be removed.

The incision is sutured and you are taken to a recovery area. An open splenectomy takes about two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the spleen was. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 6 hours, you will begin with the intake of liquids and then solid foods. We recommend sitting down and starting to walk about 8-12 hours after the intervention. You will be supervised at all times by nursing staff.

It will usually go away in one or two days after the intervention.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend the first week to avoid copious meals. Later you could eat your usual diet before the intervention.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery can take approximately three to four weeks for laparoscopic splenectomy. However, with open splenectomy, once at home, full recovery may take four to six weeks.

What are the risks of splenectomy?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Less serious and frequent risks: Infection or bleeding from the surgical wound, phlebitis (inflammation of the veins), temporary digestion disorders. Pleural effusion. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Dehiscence of the laparotomy in open surgery (opening of the wound). Fistula with output of pancreatic or intestinal juice. Inflammation of the pancreas (pancreatitis). Intra-abdominal bleeding or infection. Intestinal obstruction. Sepsis. Disease recurrence. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

In most cases, these complications are resolved with medical treatment (medications, serums, etc.), and sometimes other tests (ERCP and/or drainage) are required, but they may require a reoperation, usually urgently. , and exceptionally death may occur.

Your risk of complications depends on your overall health and the reason you’re having a splenectomy.

Gastrectomy is a surgical intervention to remove part or all of the stomach. The stomach is a muscular sac located in the upper middle part of the abdomen, just below the ribs. The stomach receives the food that comes from the mouth through the esophagus, and then helps to break down and digest the ingested food.

A gastrectomy is a surgery of medium complexity and carries a moderate risk of complications.

Gastrectomy is performed primarily to treat stomach tumors and the complications they cause. Sometimes, although less and less frequently due to the use of treatment with “stomach protectors” such as omeprazole or ranitidine, it is indicated by presenting ulcers in your stomach.

Operations used for stomach cancer include the following:

• Removal of part of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes the part of the stomach affected by cancer and some of the healthy tissue around it. This operation may be an option if your stomach cancer is located in the part of the stomach closest to the small intestine.
• Removal of the entire stomach (total gastrectomy). Total gastrectomy involves removal of the entire stomach and some of the tissue around it. The esophagus then connects directly to the small intestine to allow food to pass through the digestive system. Total gastrectomy is most often used for stomach cancer that affects the body of the stomach and that located at the gastroesophageal junction.
• Lymph node removal for cancer screening. The surgeon may remove some lymph nodes from your abdomen and test them for cancer.
• Surgery to relieve signs and symptoms. An operation to remove part of the stomach may relieve signs and symptoms of developing cancer in people with advanced stomach cancer.

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

Normally you must be evaluated by Hematology before the intervention since they must draw blood to study your blood group and make a reserve of blood bags for the day of the intervention. In this surgery, bleeding is an important complication, so we must offer you maximum safety. For your peace of mind, most of our patients do not require a blood transfusion.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a gastrectomy, your surgeon may ask you to do the following:

• Do not eat anything before surgery. You can have a sip of water with your medications, but avoid eating and drinking for at least eight hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A gastrectomy is performed under general anesthesia, so you will not be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, your health care team will insert a tube down your throat to help you breathe, place a catheter to monitor your urine, and place lines in your neck and wrist to administer drugs and learn about your heart function.

You may have an epidural catheter or injection into your spine, as well as local nerve blocks in your abdominal wall. These procedures allow you to recover with minimal pain and discomfort after surgery and help reduce the amount of opioid pain medication you’ll need.

Your surgeon will perform the gastrectomy using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) gastrectomy.

During a laparoscopic gastrectomy, the surgeon makes four to six small incisions in the abdomen. He inserts a tube with a tiny video camera into his abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the diseased part of the stomach or the entire stomach. Subsequently, a piece of small intestine must be attached to the part of the stomach that has remained or to the esophagus if the entire stomach has to be removed, to give continuity to the digestive tube.

One of the incisions will be enlarged to remove the removed stomach. The incisions are then sutured and you are moved to a recovery area. A laparoscopic gastrectomy takes between three and six hours.

A laparoscopic gastrectomy is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) gastrectomy

During an open gastrectomy, the surgeon makes an incision about 20 centimeters in the middle of the abdomen, above the navel. Muscle and tissue are retracted to reveal the liver. Next, the surgeon removes the diseased part of the stomach. Subsequently, the digestive tube will be continued through a union with the small intestine.

The incision is sutured and you are transferred to a post-anesthetic recovery area. An open gastrectomy takes between two and four hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach due to the complexity of the case.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the diseased part of the liver was. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient is transferred to the Intensive Care Unit (ICU) where he will remain for 24 hours if there are no incidents. It is possible that the anesthesiologist will remove the connection to a breathing machine in the operating room or the doctor in charge of your surveillance in the ICU will do it. You will slowly wake up from the effects of the anesthetic drugs, so you may have a feeling of not remembering the process. After your stay in this unit you will then be transferred to your room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 48 hours you will start with the intake of liquids and in the following days solid foods. We recommend sitting down and starting to walk about 24 hours after the intervention. The catheter that is inserted into your bladder will be removed in 1 or 2 days. At all times you will be supervised and helped by nursing staff.

If your surgery progresses on the floor without any incident, you will remain hospitalized for between 5 and 7 days.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend the first two weeks to eat a soft diet, foods that are easy to digest. Subsequently, all types of food will be progressively reintroduced, with possible intolerance of some of them, so their intake will be suspended and they will be tried again in the following weeks.

You can wet your wounds when you wash yourself and then dry gently with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually complete recovery can take approximately three weeks in laparoscopic gastrectomy. However, with open gastrectomy, once at home, full recovery can take three to five weeks. It will depend on your physical condition before surgery and the complexity of the operation.

What are the risks of gastrectomy?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Less serious and frequent risks : Infection or bleeding of the surgical wound, phlebitis. Delayed recovery of intestinal motility. vomiting. Prolonged pain in the area of ​​the operation.

Infrequent and serious risks : Dehiscence of the laparotomy (opening of the wound). Fistula or stenosis due to failure of the intestinal suture to heal. Alterations in nutritional status that are usually corrected with dietary supplements. Intra-abdominal bleeding or infection. Reproduction of the disease.

These complications are usually resolved with medical treatment (drugs, serums, etc.), but they may require a reoperation, usually an emergency, and in some cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having a gastrectomy.

Gastroesophageal reflux disease occurs when stomach acid frequently flows into the tube that connects the mouth and stomach (esophagus). Acid reflux can irritate the lining of the esophagus. Gastroesophageal reflux disease can usually be controlled with medication. But if medications don’t help or you want to avoid long-term medication use, surgery may be indicated.

The intervention to solve gastroesophageal reflux disease is called a fundoplication. The surgeon wraps the upper part of the stomach around the lower esophageal sphincter to tighten the muscle and prevent reflux. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. The wrapping of the upper part of the stomach can be partial or complete.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a fundoplication, your surgeon may ask you to:

• Do not eat anything before surgery. You can have a sip of water with your medications, but avoid eating and drinking for at least eight hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A fundoplication is done under general anesthesia, so you won’t be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe. Your surgeon will perform the intervention using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) fundoplication

During a laparoscopic fundoplication, the surgeon makes four or five small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to wrap the upper part of the stomach around the lower esophageal sphincter, tightening the muscle and preventing reflux. According to the studies carried out before the intervention, the surgeon will decide whether to perform a complete or partial fundoplication. The incisions are then sutured and you are moved to a recovery area. A laparoscopic fundoplication can take one to two hours.

A laparoscopic fundoplication is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) fundoplication.

During an open fundoplication, the surgeon makes a 6- to 8-inch incision in the middle of the abdomen above the navel. Muscle and tissue are retracted to reveal the stomach. Next, the surgeon performs the fundoplication by wrapping all or part of the stomach around the esophagus.

The incision is sutured and you are taken to a recovery area. An open fundoplication takes one to two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach. 

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 8 hours, it will begin with the intake of liquids and the next day, pureed food. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised by nursing staff at all times.

If your surgery goes uneventfully, you will usually go home the next day.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend eating a pureed diet for the first week until your esophagus and stomach adapt to this new situation. Subsequently, a soft diet with easy-to-digest foods will be reintroduced and meals will be divided into five times throughout the day and with less quantity. Three or four weeks after the intervention, you will reintroduce your usual diet.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery may take approximately three to four weeks for laparoscopic fundoplication. However, in open fundoplication, once at home, full recovery may take a little over four weeks.

What are the risks of gastroesophageal reflux disease surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and frequent risks: Infection or bleeding of the surgical wound, phlebitis. Difficulty burping, transient difficulty swallowing. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Bleeding or intra-abdominal infection. Viscera perforation. Stenosis. Significant difficulty swallowing. Reproduction of gastroesophageal reflux. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having a fundoplication.