Small Intestine Surgery (Enterotomy)

Small intestine surgery, medically referred to as enterotomy, is a procedure that involves the surgical incision and opening of the small intestine. This surgery is generally performed to treat certain conditions occurring in the small intestine.

Small intestine surgery can be performed for several different reasons. Some common reasons include:

• Intestinal obstruction: If a portion of the small intestine becomes blocked, surgical intervention may be necessary. This obstruction can occur due to a tumor, adhesions in the intestinal folds, or other tissue damage.
• Intestinal perforation: If a hole or tear occurs in the small intestine, it needs to be surgically repaired. Perforation can result from trauma, inflammation, or other causes.
• Fistula in the small intestine: A fistula is an abnormal connection between the small intestine and another organ or structure. Fistulas usually require surgical intervention and can be treated as part of small intestine surgery.

Small intestine surgery is generally performed under general anesthesia. The surgeon opens the affected area, removes or repairs the damaged or blocked section, and reconnects the intestines. Postoperatively, the patient requires a recovery period for bowel function to return to normal.

This surgery can be a serious procedure, and postoperative complications may occur. Therefore, when a condition requires small intestine surgery, a detailed assessment of the patient’s condition and the risks and benefits of the surgery is conducted, and a decision for surgical intervention is made. The surgeon performing the operation will determine the appropriate treatment plan based on the patient’s condition and needs.

Small intestine surgery (enterotomy) can be performed for various reasons. Here are the common reasons for small intestine surgery:

• Intestinal obstruction: Surgery may be required if a portion of the small intestine is blocked. Intestinal obstruction can occur due to a tumor, adhesions, twisting of the intestinal folds, or other causes. The obstruction prevents the passage of food, fluids, or gas within the small intestine. This condition is serious and may require urgent intervention.
• Small intestine perforation: If a hole or tear occurs in the wall of the small intestine, surgical intervention may be necessary. Perforation can occur due to trauma, ulcerative colitis, Crohn’s disease, diverticulitis, or following surgical procedures. In such cases, surgery is needed to repair the perforation and prevent the intestinal contents from spreading into the abdominal cavity.
• Small intestine fistulas: A fistula is an abnormal connection between the intestines and another organ, cavity, or the skin surface. Small intestine fistulas may arise from Crohn’s disease, diverticulitis, abscesses, or surgical procedures. Fistulas are usually corrected surgically and can be treated as part of small intestine surgery.
• Intestinal injury: Serious injuries to the small intestine can occur due to trauma or surgical intervention. For example, abdominal trauma from an accident may damage the small intestine. In such cases, surgery may be needed to repair the damaged area.
• Small intestine tumors: Benign or malignant tumors can develop in any part of the small intestine. Tumors can disrupt normal intestinal function, cause obstruction, or lead to perforation. Small intestine tumors are generally removed surgically.

Due to these reasons, small intestine surgery may be necessary. However, each case varies from patient to patient, and the treatment plan depends on the patient’s condition, symptoms, and diagnosed disease. The surgeon performing the operation will evaluate the patient’s condition and determine the most appropriate treatment approach.

Small intestine surgery (enterotomy) can provide various benefits. Here are some possible benefits of small intestine surgery:

• Relief of obstruction: Small intestine obstruction can be resolved through surgery. By removing the cause of the obstruction, normal intestinal function is restored. This helps reduce symptoms such as nausea, vomiting, abdominal pain, and bloating, and allows the patient to properly digest nutrients.
• Repair of perforation: In cases of small intestine perforation, surgery can repair the hole or tear. This prevents intestinal contents from spreading into the abdominal cavity and reduces the risk of infection. It also stabilizes the patient’s condition and prevents complications.
• Correction of fistula: Surgical correction of small intestine fistulas restores intestinal function and eliminates abnormal connections to another organ or structure. This reduces infection risk, improves nutrient absorption, and alleviates symptoms.
• Repair of intestinal injury: Injuries or damage to the small intestine can be repaired surgically. Repairing the damaged area helps the intestines regain normal function and prevents complications.
• Removal of tumors: Small intestine tumors can be surgically removed. This prevents the spread of the tumor and reduces the risk of cancerous cells spreading to other organs. Post-surgery, the tumor can be examined pathologically, and additional treatments can be planned if necessary.

Each patient’s situation may vary, and the benefits of small intestine surgery depend on the patient’s symptoms, diagnosed condition, and other factors. The surgeon performing the operation will evaluate the patient’s condition and explain the potential benefits of the surgery.

After small intestine surgery, nutrition is extremely important. Surgery can affect the normal function of the digestive system, and the intestines may need time to heal. Therefore, a special nutritional approach is usually recommended during the postoperative period. Here are some key points highlighting the importance of nutrition and recommendations for patients undergoing small intestine surgery:

• Recovery and tissue repair: After small intestine surgery, the intestines require time to heal. Proteins, vitamins, minerals, and other nutrients help repair tissues. Protein-rich foods are especially important post-surgery. Foods such as chicken, fish, eggs, dairy products, legumes, and tofu are good sources of protein.
• Ease of digestion: The digestive system may be sensitive after surgery. Therefore, foods that are easy to digest and gentle on the intestines should be preferred. Thinly sliced fruits and vegetables, pureed soups, yogurt, rice, and boiled chicken do not strain the digestive system and facilitate nutrient absorption.
• Fluid intake: Adequate fluid intake is important after surgery. Fluids help maintain hydration and support proper intestinal function. Water, herbal teas, low-sugar fruit juices, or electrolyte-containing sports drinks can be beneficial.
• Small, slow meals: After surgery, the intestines may have reduced capacity, so eating small portions slowly is important. Chew food thoroughly and eat gradually. Multiple small meals throughout the day can make digestion easier.
• Guidance from a dietitian: After small intestine surgery, it is important to create a personalized nutrition plan under the guidance of a dietitian. Each patient may have different needs, and the nutrition plan should be tailored according to the type of surgery, the patient’s symptoms, and individual requirements. The dietitian evaluates the patient’s nutritional needs and provides appropriate recommendations.

Nutrition after small intestine surgery plays a crucial role in supporting recovery and maintaining digestive health. Patients who have undergone surgery should stay in contact with their doctor and dietitian and follow the recommended nutrition plan.

Small intestine surgeries are typically performed in modern surgical centers using advanced surgical technologies. The method of surgery and the technologies used depend on the patient’s condition, the surgeon’s preference, and the hospital’s equipment. Here are some commonly used technological methods in small intestine surgeries:

• Laparoscopic surgery: Laparoscopic surgery is a method in which the surgeon makes a few small incisions to visualize and operate on the small intestines. A laparoscope, a thin tube with a camera and surgical instruments, is inserted into the abdominal cavity. The surgeon can view the internal images on a large screen and access the small intestines to perform the necessary procedures.
• Robotic surgery: Robotic surgery involves the use of a specialized surgical robot. The surgeon operates the robot through a control panel to perform the procedure. Robotic surgery can be used in small intestine operations due to its precise manipulation, three-dimensional imaging, and tremor-reducing capabilities.
• Surgical laser: Laser technology can also be used in some small intestine surgeries. Surgical lasers use high-energy light to cut tissue and perform coagulation. The laser allows precise cutting of intestinal tissue while helping to control bleeding.
• Electrocautery: Electrocautery is an electrical device used in surgical procedures. In small intestine surgeries, electrocautery can be used for tissue cutting and coagulation. This helps control bleeding and facilitates the surgical process.

These technologies are some of the common methods used in small intestine surgeries. However, the choice of technology for each surgery depends on the surgeon’s experience and the hospital’s resources. The surgeon performing the operation will select the most appropriate technology according to the patient’s condition and the requirements of the surgery.

Small intestine surgery is generally a necessary treatment for serious conditions. However, in some cases, alternative treatments may be used before or after surgery. Here are some alternative treatment options for small intestine surgery:

• Medication therapy: Medications can be used for certain small intestine disorders. For example, in conditions such as Crohn’s disease or intestinal inflammation, immunosuppressive drugs, corticosteroids, or anti-inflammatory medications may be prescribed to reduce inflammation and control symptoms. Medication therapy can be used as an alternative to surgery or to support recovery after surgery.
• Nutritional therapy: For some individuals with small intestine disorders, a specialized nutrition plan can be implemented. For instance, in inflammatory bowel diseases like Crohn’s disease, liquid diets or specialized nutritional formulas may be used to help manage symptoms and allow the intestines to rest. Under the guidance of a dietitian, nutritional therapy can serve as an alternative or supportive measure to surgical treatment.
• Intestinal rehabilitation: In certain cases, intestinal rehabilitation may be applied to treat small intestine disorders. This includes a set of treatments and methods aimed at improving intestinal function and digestion. Intestinal rehabilitation can involve strategies such as dietary modifications, probiotics, prebiotics, enzyme supplements, and exercises that enhance bowel motility.
• Alternative therapies: Some individuals may wish to try alternative therapies for small intestine disorders. These can include acupuncture, hypnotherapy, herbal treatments, or other complementary and alternative medicine practices. However, more scientific evidence is needed regarding the efficacy and safety of these treatments. It is important to consult a qualified healthcare professional before attempting any alternative therapy.

Important note: Alternative treatments may not be suitable for all small intestine conditions or for every patient. It is essential to consult a healthcare professional to evaluate treatment options and determine the most appropriate approach. Each case is individual, and the treatment plan should be personalized based on the patient’s specific condition, symptoms, and needs.