Questions About Proctectomy Surgery

What do I need to know about this surgery?

It's a pain in the butt. 😁 Seriously, they knock you out, they gut you like a fish, sew everything together, and then you heal. 🤷‍♂️ Sitting is the biggest issue after surgery, so be prepared to lay, stand, or try to sit on one cheek or the other. Healing time is very individual, and nobody can tell you a specific amount of time. You want dissolvable stitches. Once you heal properly, there's not much difference from before surgery. Done robotically will leave a few little scars. If they open you up, you'll have a big scar.

Yup. He told me the same exact thing last year when I asked him the same question... Replied exactly. And guess what? He was spot on.

No sugar coating. But don't let the graphic explanation scare you. He's a sweetie. He was right.

Sooo. For me, recovery was 6-8 months. I was back to work full time.

I would like to add to his explanation:

Watch out if you blow stitches in your sewn-up butt. Gotta learn to roll out of bed. Keep legs together. You will need help at home for a week or two. Stock up on food. No bending. No driving for a while. They advise to walk... it's more like shuffling at first. Slowly...

Need a soft pillow. Not the donut type. No. Others will offer a name brand.

Ice down there helps with swelling. You will have meds to control pain.

Leakage is common down below. I had that fixed twice! After the surgery while recovering.

That's me and a few other members did get an infection

or an abscess. Also find out if your butt cheeks will be sewn up after your butt hole is... you feel that tightness. I didn't know my surgeon did that. Awkward surprise. One year post-op... still feel it. They do that to prevent butt hole stitches from opening. "A short bridge between two mountains" ha ha.

Money? Yeah. Income... Lucky I had disability insurance from my job. It goes quickly. I ran out of it two months prior to RTW.

So avoid that anxiety if you can. If you're still working... contact human services and see what the payments will be. I think you probably know all this. I did, but I still went broke. That sucked.

Also remember once you're on that table... it's the doctor's call to change plans.

We went in robotic thinking... Was cut open due to unforeseen circumstances.

I'm probably going to invite some more commentary with this, but stoma placement can be important.  I find surgeons don't give that sufficient consideration because its implications are all post-surgical.  I like mine below the waist and find it most convenient there for a variety of reasons.  However, I suspect there are some who might have other opinions.  Let's see...  

Research as much as you can…but always remember - you are unique and no one else's experience will be like yours. It could be rough, but it could go smoothly.

My stoma surgery was not pre-planned - more of an emergency. I do have a friend who lives in Switzerland and had his surgery there. I was impressed when he was allowed to participate in sketching the location on his lower abdomen (prior to surgery) for a colostomy. It sounded as though his whole experience was well planned. I think if you are able to participate in the plan, it would be a good thing…after all, it is your belly…jb

My Ostomy Journey: Jearlean | Hollister

An ostomy is best placed on a flat portion of the abdominal wall that can be easily seen and reached by you.

The ostomy is placed through the muscles that run up and down just to the left or right of the midline in your abdomen. A colostomy is usually placed to the left of your navel and an ileostomy to the right.

The ascending colon goes up the right side of your body. The transverse colon goes across your upper abdomen. And the descending and sigmoid colon go down the left side of your body to your rectum. An ascending colostomy typically goes on the right side of your abdomen. A descending colostomy typically goes on the lower left side of the abdomen. A sigmoid colostomy is also typically on the left side of the abdomen. A transverse colostomy will typically be somewhere across the upper abdomen. I have a transverse colostomy and it is "officially" said to be in the upper right quadrant of my abdomen. It looks to me to be in the upper center of my abdomen. Most colostomies are attached to the sigmoid colon, which is probably why you hear colostomies are on the left.

Stoma construction can be technically difficult for the surgeon because the bowel, which is attached to the blood supply, may not easily reach the skin surface.

If the blood supply is compromised, stomal necrosis can occur; if an adequate amount of bowel is not brought to the skin surface, stoma retraction can occur.

A thick, obese abdominal wall may make it difficult for the surgeon to free up enough healthy bowel to create a protruding stoma, which often results in the creation of a flush or retracted stoma.

Thus, there are anatomical considerations that may outweigh our stoma placement desires.

Yep, placement is crucial. I would go nuts if mine was below my waist like yours. Mine is in line to the left (as I look down) of my belly button about 2 inches or so. Works great for me. It's all individually determined. Work with your ostomy nurse and/or surgeon to figure it out. Also, remember to ask for a stoma that sticks out a bit rather than flush (or maybe you already have a stoma and are going in to clean things up 🤷‍♂️).

My experience? I had no choice. The nurse came in. She said to stand up.

Where do you wear your belt?

I showed her.

How high do you wear your pants?

I examined the area and left.

I was still phased about just finding out I would be wearing a bag until I die. I had no questions or idea what was going on. Sadly.

I guess the surgeon and/or nurse knew best.

However, if anyone asks me where I want a stoma?

I'd say I'd prefer it on another person.

My colostomy is positioned the same as yours. Easy to see, and on a relatively flat part of my stomach. Good placement makes a huge difference. Since mine was emergency exploratory surgery, I'm very pleased my surgeon put it exactly where I needed it.

Thanks for your response. I currently have an ileostomy, so I am hoping for laparoscopic surgery to lessen the violation of my body. I didn't think of dissolvable stitches, so I will discuss that with my doctor.

Thanks for your words of experience. I am retired, so I don't have to worry about work. And my Ontario, Canada, health insurance, as well as my private insurance, will cover any extra expenses incurred.

What kind of pillow do you recommend?

Thanks for your reply. I forgot to mention that I already have a stoma. It is just the removal of the rectal stump that will make up the surgery.

Since you already have the ostomy part, you'll just have to deal with the not-sitting part and your butt being tender for quite a while. Keep the area clean and dry as best you can because it's about the most ideal spot for infection to develop.

Thank you, I appreciate your advice.

You're welcome. Plenty of us have had the surgery; ask anything you want about it.

Morning. Just saw this. You may not need to buy one. The hospital likely will give you one. You should perhaps consult the hospital or surgeon prior.

It's a safe bet they will give you one. Butt pillows are on Amazon, I'm told. Even a Google search would be helpful.

The idea is to keep your cheeks close together, not apart.

Two towels under your butt cheeks would do. An ice pack between them would ease swelling if you can manage that a bit later. You will swell up. A nurse visiting me suggested ice-cold washcloths (kept in the freezer) worked really well. Those "got in there" softly as they conform by melting. A game changer for sure.

I don't know what to ask. Any advice is welcome, especially about post-op care.

Thank you! This is solid advice and helpful to prepare.

Indeed. Infection. Twice. The first drain, he didn't think I needed an antibiotic.

You demand it if... if... an infection develops down there.

My surgeon messed up. That was his dumb ass fault for thinking, "it looks good." When I asked why he didn't prescribe one.

I will be asking my doctor about antibiotics for sure. I don't want this to be more challenging.

Cool. I just remembered something about vitamin intake prior.

Members chimed in last year about supplementing B6, B12, and D3 vitamins, which helped them recover faster. It was a good idea. I did it. Certainly can't hurt.

No one ever thinks about prior supplements to take. These three were suggested.

I went with gummy form. Not pills, tablets, nope. I think they really aided.

Eat as much protein as you can every day. Protein is the main thing to heal wounds.

Thanks again, Warrior, for the hint. I am taking more Vitamin C currently and already take D3. I'll bump up my B's now as well. Like you said, it can't hurt.

Interesting... this would not occur to me, but I'll eat more chicken and some beef. Pork is not my thing lately, as it aggravates my gout.