Patients requiring surgery need special attention to fluid and electrolyte balance. Get the patient's condition back to near normal lessens the risk of surgery
Small bowel surgery is usually performed under general anesthesia with the patient supine (on the back)
A nasogastric tube is inserted through the nose into the stomach for drainage
A catheter is placed in the urinary bladder to monitor urinary output
Central venous catheters and/or an arterial catheter may be placed
Midline (up and down) or transverse (from side to side) incisions may be used
Different types of drains may be left in the abdominal cavity and brought out through the abdominal wall. The amount of drainage determines removal
Temporary feeding tubes may be placed in the stomach or small bowel
Benign or malignant (cancerous) tumors of the jejunum or ileum are treated with wide resection of the bowel and adjacent mesentery with anastomosis (suturing the two ends of the bowel together (Figure 6)
The amount of small bowel to be resected is determined and two special clamps placed on the bowel at each of these points
The bowel is cut between the clamps 3. The vessels in the attached mesentery are clamped, cut and tied
The resected bowel is removed
The two ends of the bowel are then brought together and sutured or stapled together
The abdomen is closed with sutures
Bringing a loop of small bowel out through the abdominal wall (enterostomy) is seldom necessary. It is necessary when there is concern about the anastomosis healing or adequacy of blood supply