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Apr 10, 2023

Preparing for Reversal Surgery - Questions for the Surgeon

The topic at hand is about preparing for an ileostomy or colostomy reversal surgery. This is a significant step for anyone who has had a stoma, and it's important to be well-prepared for the surgical consultation. Here are some key points and questions to consider asking your surgical team to ensure you have all the information you need:

1. Clarify the type of reversal you are having, whether it's an ileostomy, colostomy, or J-pouch, and discuss the possibility of needing another ostomy if the reversal doesn't succeed.

2. Inquire about the success and failure rates of the procedure:
- What is the overall failure rate and what are the common reasons for failure?
- What is the likelihood of needing another stoma, either temporarily or permanently?

3. Discuss potential complications and their management:
- Understand the risk of postoperative ileus, where the intestine might not "wake up" after surgery, and the possibility of needing an NG tube.
- If you have allergies to pro-motility drugs, ask for alternative medications.
- Talk about the formation of adhesions and how they might affect the surgery.

4. Confirm the pre-reversal tests and investigations:
- A colonoscopy is often done 1–2 days before the operation to check the health of the rectum and colon.
- Ask if any imaging or tests like manometry are needed to evaluate pelvic floor or sphincter function.

5. Get details about the surgery itself:
- Will the surgery be open or laparoscopic?
- How long is the surgery expected to take?
- What is the anticipated length of the hospital stay?
- How will the old stoma site be closed?

6. Understand postoperative recovery and rehabilitation:
- Early walking is crucial to reduce the risk of ileus.
- Be prepared for temporary bowel-control issues and consider using products like adult diapers, baby wipes, and diaper-rash ointment.
- Ask about pelvic-floor therapy and exercises to strengthen continence muscles before surgery.

7. Discuss lifestyle and dietary considerations after the reversal:
- What are the expected short-term diet restrictions and long-term eating patterns?
- What are the activity limits during recovery and after full healing?

8. Ask the surgeon about:
- Warning signs of complications to watch for at home, such as fever, vomiting, severe pain, or inability to pass gas or stool.
- The follow-up schedule and who to contact after hours if needed.
- Their personal experience with reversal surgeries, including the number performed and their outcomes.

These questions and considerations can help you feel more prepared and informed as you approach your surgical consultation and potential reversal surgery.
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