Surgery - robotic sigmoid colon resection - diverticulitis

I wanted to share my recent experience of a robotic sigmoid colon resection. I am now 5 weeks post-surgery and think this is a good time to give an account of what it involved for me.

I am a 36 year old male who has had 3 bouts of diverticulitis within as many years, 1 of which required 4 days in hospital with IV antibiotics. I also get regular flare ups, with pain in the lower left abdomen followed by sprinting to the toilet after eating. This was happening so often that I decided to go private and see a gastro consultant, who referred me to a surgeon. After speaking to both I decided to have the surgery - the risk of getting a perforation or other complication was only going to increase with each new infection.

The day before the operation I had to have my final meal at 8am (something soft and easy to digest) followed by bowel moviprep laxative courses at 10am and 2pm. I was only allowed clear fluids throughout the day, and a final glass of water at 6am on the day of the surgery.

I arrived at the hospital at 7am as directed and taken to my room to settle and get into the surgery clothes. I was then visited by a nurse, then the anaesthetist and finally the surgeon. They all explained the process, what to expect and the potential risks (converting to open surgery, having to have a stoma etc). I then signed a consent and was taken to the surgery floor.

I was then prepped for surgery in a room adjacent to the theatre. They injected me with something to relax me - I think fentanyl - and relax me it did! If given the option, take it. I was then given an epidural (which took some time - my spine was playing hard to get!). Lastly they gave me oxygen and the anaesthetic and that’s the last thing I remember.

Next thing I know I’m waking up in a recovery bay with a nurse monitoring me very closely. I have cannulas and IV drips in both hands, an NG tube down my throat and a catheter in my urethra. I was very out of it at this point but have a vague memory of my surgeon appearing and saying it went well. I noted I didn’t have a stoma. I was later taken back to my room.

I later woke up a bit more and the surgeon came again - confirmed everything went well. I’m not going to sugar coat it - waking up with that many tubes attached is scary and uncomfortable. None are particularly painful, but it takes adjusting to. I was also on oral morphine and IV paracetamol to control the surgery pain. I didn’t get out of bed that first day - I just called for nurses when I needed more painkillers and otherwise rested.

On the next day the physio got me up for a short walk and helped move the IV and catheter box. It wasn’t too awful but I was on a lot of morphine. I later complained of discomfort caused by the catheter and they removed it - again, it doesn’t hurt, just feels odd. At this stage your bladder may feel strange - I lost the urge to know when to go so had to get up frequently. I was unable to pee into a bed pan or anywhere other than the bathroom with the taps running. I had to relax and it would come.

That same day I unfortunately had a complication that has just about now healed. The area around my main lower incision (right above the bladder) suddenly swelled and turned hard and very, very painful. The nurses and doctors spoke with the surgeon and confirmed it was a haematoma: the torn muscles from the surgery leaked blood which raised to the surface and caused the swelling. I was told that it would eventually be reabsorbed into the body. 5 weeks later it's almost gone.

The next day I had my NG tube removed which was a blessing. It did cause a scab/bleeding on my nose which I’m told is not normal. I was given a cream to apply daily.

As the days went on I continued to be in pain, I think more than expected. The doctors decided to open my main incision and try to draw some of the blood out. Agonising experience. Nothing really came out which I think surprised them. I also had a CT scan which confirmed internally everything was normal. It wasn’t until 2 weeks later when the blood started coming out (and still is!)

For the pain meds, I was tripping way too much on the morphine so the pain consultant came to visit me. He changed me from morphine to Oxycodone. Oxycodone did the trick but it makes you very zoned out. Good for sleeping if you’re having a rough night.

My next issue: the nurses were really struggling to give me a new cannula (all my accessible veins were bruised/collapsed by this point). 3 nurses tried over 1.5 hours and it was agony. The nurses wanted to put a PICC line in me (which is a catheter-like rubber tube). This would have involved using a machine to detect a larger artery in my upper arm, cutting open the artery and inserting the PICC line straight into it. The rubber tube is then moved up the artery and towards the heart. Apparently it would have made administering drugs and taking blood simpler. However, at this point I was pretty fed up (and panicked) and couldn’t face another procedure so I pushed back a bit. The nurses called the surgeon who told them to hold off until he sees me.

The surgeon said I needed to start eating (I had avoided it tbh - I had zero appetite and was scared that my gut wasn’t ready). So he said no PICC line, no cannulas, take all medicine orally and start eating a soft diet. He was right. Once I started doing this I had my first bowel movement (very loose with a mix of blood - totally normally). From that moment on I started feeling a bit less awful. I also stopped the Oxycodone and took on a bit more pain - opioids can constipate you badly and I prioritised my stomach over the pain. That's not necessarily for everyone but it was the right choice for me.

Overall, I was in hospital for 6 nights. I think I’d have been out sooner if it wasn’t for the haematoma and if I’d started eating sooner. I went back to my parents for a week, and then back to living on my own. So really it took 2 full weeks for me to be able to move about, cook, clean and take care of myself.

One thing that really surprised me is how quickly I returned to regular, normal bowel habits - basically the day after I got back from the hospital. I have not had to take the laxatives that were prescribed to me. I am also already back to a fairly well balanced diet.

Any questions/worries, just shout - happy to answer.