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Stoma surgery can be keyhole or open surgery
Planned stoma surgery is usually carried out by keyhole surgery (you may also hear this called 'laparoscopically'), which means the surgeon makes small incisions on your abdomen. In some cases, though, you might need open surgery, called a Laparotomy. This involves a larger incision down the middle of your abdomen. Before your operation, your surgeon and Stoma Care Nurse should have fully explained the reason why you will be having the particular type of surgery. If you still feel unsure or confused, make sure that you ask them any questions you may have. How long you will be in the operating theatre for will depend on the type of surgery that you are having.
Anaesthetic and pain relief
The first thing that will happen when you go for your surgery is the anaesthetist will deliver some drugs, via a needle in the back of your hand, to send you to sleep throughout the procedure. You should have been made aware of pain relief options before your surgery starts. Pain relief might be in the form of an epidural, (pain relief and local anaesthetic delivered into the base of your spine) or a pump delivering pain relief into the needle in your hand. You can be in control of both of these options yourself, through a button you press to deliver pain relief when you need it - don't worry, it is carefully controlled so that you cannot deliver too much.
Be prepared for a number of tubes
Don't be alarmed if you require a number of tubes throughout your stoma surgery - they are a normal part of the process. You may need a urine catheter - a tube put into your bladder to allow urine to drain whilst you are unable to control this yourself - and a nasogastric tube, which goes into your stomach via your nose to let stomach fluid drain into a bag, stopping you from feeling and being sick. Some people also have an abdomen drainage tube during stoma surgery. This lets your surgeon introduce water and air into your abdomen during the procedure, as they can drain out via the tube. You will also have tubes for intravenous antibiotics, medication to stop you from feeling sick and fluids to keep you hydrated. All of these tubes will be removed as you progress post-operatively.
Immediately after stoma surgery
Immediately after surgery, your stoma will have a clear bag covering it. Your Stoma Care Nurse will come and see you the day after your surgery, to start teaching you how to care for your stoma (although it might not work for a few days until you start drinking and eating). At first, your stoma might look bigger than you'd expected. This is because of excess fluid - it'll go down to a normal size in 2-3 weeks. You'll also notice stitches around your stoma. These are to hold the stoma in place until it heals and adheres to your skin but they'll gradually come away. If they don’t after 2-3 weeks and start to become irritating, your Stoma Care Nurse can remove them. In the immediate aftermath of your stoma surgery, you'll also be seen by your surgical team, a physiotherapist, a dietician, and other specialists involved with your care. Don’t be afraid to ask questions or to tell your team how you are feeling. They are there to help you to adapt and support you through your operation, hospital stay and discharge home.