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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.
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@lilbear
Remember that it is always your right to obtain a second opinion if you feel that you are not getting the treatment that you need for this pain.
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2 Reactions@jsal11 Great for you! Share with us and ask any questions that we can try to answer. Keeping in mind everyone is different in the own way in regard to health.
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1 ReactionI am a 70 y.o. female who had a robotic assisted sigmoidectomy in June of 2025 due to a stricture from diverticular disease. What a long, strange trip it's been. To begin with, I had experienced a sudden change in bowel habits early that year (i.e., unable to pass stool without excessive straining). I had appointments through my PCP, PA, and extensive tests they informed me it was poor pelvic floor muscles and they wanted to send me to rehab. I insisted that it was more than that and requested a CT scan. CT scan showed a stricture secondary to an adhesion (from my hysterectomy several years prior) and some diverticular disease. Previously, never had an issue with diverticulosis. So, surgery was schedule for early June. The surgery went well, I was home day 2 and recovered well. Then, a few months out I noticed I was having extreme difficulty passing stool. I am mindful of my diet, exercise and drink over 2L of water daily. I thought it may be an obstruction so another CT scan was ordered. This showed nothing. Now, 7 months post op I am having extreme constipation. I've tried Miralax, docusate sodium tablets nightly, milk of magnesia and fleets enemas when it gets bad. I'm passing gas, eating fiber, exercising, and drinking plenty of water.
I think my "rant" is that the surgeon did not do a good job in explaining and educating about the possible long-term side effects of the surgery, nor did a good job in follow up. My situation prior to surgery has increased exponentially and I honestly don't know where else to turn.
Has anyone had this experience or suggestion(s)? I'm at my wit's end.
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2 Reactions@lwood55 - welcome to Mayo Clinic Connect. Sorry to hear that you are feeling like your surgeon did not do a good job explaining and educating you about possible long-term side effects of the surgery or in follow up.
I believe you are saying you feel you are worse off now than before you had your surgery? What were the deciding factors in having the robotic assisted sigmoidectomy, such as symptoms you were experiencing or how they affected your quality of life?
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1 Reaction@lwood55 I had also robotic resection of sigma three months ago, due to 4 episodes of diverticulitis-after resection struggle also with constipation, i help me with Donat (magnesium) but the stool is generaly Bristol 2 to 3, and very wide. Nevertheless that, with effort, a lot of water drinking (3 liter each day), dieta with fiber, joga and taichi exercises i found in internet, and 1 hour of hiking daily, I achieve to go daily, feeling always certain pain. Before the chirurgie I never had such difficulties. But by the moment, this changed my quality of life. I thought that maybe with the time it will go better, but reading your comment, it seems that it can also be worse.
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1 Reaction@lisalucier - Thank you for your reply. As an experience ED RN myself, I know how important education can be to patients, not just the immediate effects of surgery, but what to expect long term and having systems in place to provide follow-up.
I began having symptoms of being unable to pass stool in December of 2024. I contacted my PCP who referred me to G.I. The PA who was assigned to my case thought I had pelvic floor dysfunction and sent me for anorectal manometry testing. Since I had 2 very large babies, I told her I know that my pelvic floor muscles were shot as I've had two bladder slings, and a hysterectomy secondary to uterine prolapse. After the test concluded, the PA suggested I attend some therapy sessions. I contacted my PCP and told her that it was something more than this and would she please order a CT scan for me and colonoscopy, which she did. The CT scan showed a significant sigmoid stricture, and the colonoscopy could not be performed because the stricture was so tight, a pediatric scope could not be inserted. Thus, they sent me to the surgeon. Three months later in June, I had the surgery.
My decision was guided by the surgeon as she strongly recommended the robotic surgery. During my session with her, I stated that I would be glad to be "normal again." She gave a quick laugh and said, "You'll never be normal again." She did not go into any specifics but explained how the gut needed time to relearn how to operate post surgery.
All of that being said, I recently contacted her with my concerns about severe constipation and she suggested I begin taking a fiber supplement like Benefiber, which I began 2 days ago, along with drinking over 2L of water daily. I've also been making sure to intake 21g of fiber daily. So far, no bowel movement but lots of bloating which is to be expected.
Finally, after having been active, eating healthy, etc., it is frustrating and certainly affects the mood when your body doesn't work as it used to. I'm going to give this a few more days to see if it works. If not, my surgeon suggested contacting my PCP, then get a referral to GI. So, months more of waiting if I have to go that route. I'm trying to stay positive, but overall, it is definitely affecting my QOL.
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2 ReactionsI'm just so happy things got better for you. I hope it lasts your lifetime. I'm going to talk to a surgeon in March about rectopexy and pelvic prolapse surgery. Scared to death. Never had surgery and am afraid once you start it doesn't ever stop.
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1 ReactionYour description of events ,behaviors while in hospital sound like mine with sticks and I eventually got a PICC line which nurses at first refused to get my blood from Piic for labs but they finally found a nurse who knew how to draw and all the sticks stopped. To this day my antecubital veins are shot. Surgeons need to be more descriptive about what can happen instead painting a rosy picture bc things happen more than they say. Scar tissue called adhesions can happen while healing and it is not the surgeons fault. Some people just overheal like I did. The surgeon went back in via colonoscopy and stretched my anastomosis so stool could go through. I still have to do my part by chewing good and eating easy to digest foods ,very small frequent portions.
Prayers for all of you. Its tough.
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2 Reactions@cc510 Surgery can be a game changer so try not to be afraid. More often than not surgery goes very well, and if it corrects your problem, then that is exactly what it is meant to do. Prayers and positive thoughts your way!
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2 Reactions@lwood55 thank you so much. I appreciate your words. I wish there were more people that would post the positive results but I’m sure those are people that have just moved on in life. If I do this, I will come back just in order to hopefully encourage others if things work out.
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