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Open Rectal Surgery

What is Rectal Surgery?

The rectum is the lower part of the large intestine that is connected to the sigmoid colon (the lowermost part of the colon). The colon and the rectum (bowel) function to store and expel digested food and waste. 

Rectal surgery is the surgical removal of all or a part of the rectum. Rectal surgery is performed to prevent and treat various medical conditions associated with the rectum including rectal cancer, ulcerative colitis, inflammatory bowel disease or Crohn’s disease.


Routine tests such as blood testing, X-ray, MRI or CT-scan are usually performed to diagnose the disease. Your doctor will perform a complete physical examination to make sure you have no conditions which might negatively affect the surgical outcome.

Preparation for Surgery

Talk to your doctor about the medicines you are taking and those you should stop taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. You must stop smoking or drinking alcohol at least a week before the surgery. Do not eat or drink 6-8 hours before the surgery. Your bowel must be empty before the surgery. Laxatives and enema are used to cleanse your rectum thoroughly.

Open Rectal Surgery

An open procedure is recommended under certain conditions including:

  • The organs are not able to be clearly visualized with a laparoscope
  • Obesity is present
  • Excessive scar tissue is present due to previous abdominal surgery
  • Large tumors are present

The procedure is performed under general anesthesia. A large incision is made on your lower abdomen. The damaged part of your rectum is identified and resected (cut out) by using special surgical instruments. At the end of the surgery, the healthy ends are reattached, the incisions are closed with sutures, and a dressing is applied.

In some cases, the complete rectum is removed and the anus closed (Abdominoperineal resection) and you will require a permanent colostomy. An opening called a stoma is created by your surgeon on the outside of your body, through which feces will pass, be collected into a colostomy bag.

Recovery after Surgery

You will be discharged a few days after the surgery. Following the surgery, your surgeon may recommend that you follow certain measures for a successful outcome:

  • Retain the dressing over the incision for the first few days.
  • Keep the surgical area clean and dry.
  • Pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed to manage pain.
  • Your surgeon may give you activity restrictions, such as not to lift heavy objects.
  • Maintain a healthy diet. You are advised to get out of bed and move around as soon as possible, safely. 
  • Regularly follow-up with your surgeon.
  • Begin exercise, under the guidance of your doctor.

When to call a Doctor

Call your doctor if you experience symptoms including:

  • Fever and chills
  • Increased pain
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Leg pain

Complications of Open Colorectal Surgery

The complications may include:

  • Infection
  • Injury to the uterus, bladder or blood vessels
  • Formation of scar tissue
  • Lower intestinal bleeding
  • Incisional hernia
  • Sexual problems