Major bowel surgery usually involves removing segment of the disease colon or rectum. This can be done via a variety of approaches including open surgery, laparoscopic surgery or robotic surgery.

The involved segment of the bowel is freed from its attachment and its blood supply isolated. The involved segment of bowel is then removed along with its blood supply and surrounding lymph nodes. The ends of the bowel is then joined together (anastomosis) using sutures or mechanical stapling device. For some patients, a temporary stoma (bag) may be required. For some patients, a permanent stoma may be required.

Patient can usually eat and drink straight away after surgery and is expected to stay in hospital from 4 to 7 days depending on the type of surgery.

For most elective bowel surgery, Enhanced Recovery After Surgery (ERAS) is practiced. It is multidisciplinary care pathway designed to improve recovery after major bowel surgery. It is used in both open and laparoscopic surgery. It involves a variety of measures such as improved anaesthesia to improve post operative pain management, avoidance of bowel preparation, early introduction of diet to improved gut function, early mobilisation to avoid muscle wasting, avoidance of unnecessary instrumentation such as nasogastric tubes and drains as well as better education of patient on the process and expectations after surgery.

All surgery involves risks. General risks involved with any surgery includes wound infection, bleeding, thromboembolic events (clots in your legs or lungs), chest infection, cardiovascular events (irregular heart beat, acute cardiac event, stroke etc) and risks involving anaesthetics.

Specific risks of bowel surgery includes anastomotic leaks (failure of your join to heal properly), ileus (delay in your bowel function returning to normal), iatrogenic injury to other organs (injury to other organs during surgery) and development of hernia long term.