Surgery methods?

Hi all!

My GI has made the decision that I need surgery (total pro ticketing with ileostomy, then j pouch) after I my c diff is fully treated (on day 4/14 of metronidazole). I informally talked to my neighbor who is a colorectal surgeon, and he was saying that I would probably have the same size scars whether the surgeon does it laparoscopically or robotically because of my size (I'm 21, 100 pounds).

I was wondering if anyone knew the difference between these methods and the difference they make in recovery? I have an official consult with a surgeon on Wednesday, so I'll get answers then. But I also find it helpful to hear from those who have gone through it themselves!

Any insight into the initial surgery process would be so unbelivably helpful. As you could imagine, thinking about major surgery at 21 is very intimidating.

Thanks so much everyone :)

ks1905 said...
Why do you need surgery because of c.diff? Seems like you only treated it with Flagyl, normally IDB patients they start us with Vancomycine which is more affective for treating C.diff.

If repeat courses of Vanco doesn't work then there is a new drug called Dificid which is even more effective. And if that doesn't work then there is FMT which the FDA approved a few years ago.

Flagyl normally doesn't work for IDB patients with C.diff, it seems pretty silly to recommend surgery after only treating you with Flagyl.

I agree. Flagyl does not work well for C. diff in Ibd patients.
You need to do a 14 day of vanko,
Should you still have c diff than there is dificid or Fmt.

Where are you located? I would highly recommend that you get yourself to a new gastroenterologist who specializes in Ibd. I don't like to say this but your doctor sounds like he has very limited to no experience in Ibd.
Preferably one who practices out of an academic institution.

Laparoscopic may be easier for healing time. But I really don't think you need to be looking at surgery right now.

What UC meds are you on? What have you tried in the past.

It is possible the c diff is mimicking a terrible flare. Have you been tested for cmv.
You can consider enrolling in a clinical trial if you do not want to have surgery. If you just want to be done with the UC than surgery is something that most fine liberating. You can head over to the ostomy forum for tips and advice.
You can do a pouch made out of your small bowel
That usually requires 2-3 surgeries depending on the severity of condition.
You can also do a one step permanent illeostomy.
Make sure that you find an experienced surgeon who has done many jpouches if you want to go that route.

Clear the c diff, reassess afterwards. Delay surgery until you know what's going on. With c diff you have no idea if your uc treatment is actually working. It could be. Cdiff and uc symptoms are identical.

In regards to any scars, there is always a chance that you could need open surgery. The surgeon will not know until you are under during the procedure. I was supposed to have Lapro but due to a previous surgery I developed a lot of scar tissue in my abdomen and he had no choice but to do open surgery. I woke up with 50 staples down the middle of my abdomen. If you've not had any prior surgeries you should be fine with lapro. Those incisions will vanish like magic

I had laproscopic surgery, not robot assisted and I have the scars. I don't think it's true that they are the same regardless of which surgery you choose. I have the c-section type of scar in my bikini area and I have the stoma scar. That's more scars than you would have with the robotic assisted I believe. I saw atwoodt had that procedure and she doesn't have the bikini scar, at the same time, I believe she had a couple smaller incisions on her abdomen that were visible in a bathing suit. She has really fair skin and heals a lot better than I do from scars. I have olive tone and mine will probably never fade to 100% perfect like very fair skin does. I think, with my skin tone, what I had was probably better for me. If I had multiple incisions on my abdomen, they would all be visible, at least the bikini one is hidden 99% of the time - even with skimpy underwear or bikini bottoms. If I were really fair skinned and I healed better, I think the robotic assisted would have produced better results so far as scarring goes. It's individual. I was really concerned about scars going into surgery, and as much as I don't like having them, they don't bother me so much knowing it was this or never leave the house without worrying about pooping my pants. I am 5'3 105 - if that matters. I think atwoodt is tiny too. We are both in our 30s and had pretty easy recoveries. I had 3 steps and she had 2.

I totally get what you're saying. I felt like even if I got through my last flare up, I would be back in these same shoes in a year or two. From my UC history, I would have *maybe* one good year from a medication, and then I'd be back to square one. I am just 6 months from take down this week. I am med free and I have been doing well. For once, I am looking forward to a healthy future, not worried about what's going to happen with my UC. I want to travel and go places, take a long car ride, plan a trip, go on a boat... It was too limiting for me to be near a toilet all the time. Not to say this is the greatest thing ever, I go to the bathroom a lot more often than a person with a functional colon, but no more often than I pee and it's on command, so if I go to pee, I empty (unless I really sense that I don't need to).

I was in the EXACT same position as you. I had failed all drugs, Entyvio was my last hope and it failed. My quality of life was terrible. I was confined to my house because I had countless accidents that I just could not hold no matter how hard I tried. I was wearing diapers all night and day and changing constantly. One day at work I had an accident and I finally said I've had enough. Now, after all I've been through I have my quality of life back and that's what's important