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length of bowel removed."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"After return of bowel function, tolerating diet and surgeon clearance; open surgery or complications delay flying; thrombosis prevention advised."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"First review before flying home; wound and any sutures or staples checked."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":42,"unit":"days","qualifier":"Review of pathology results and recovery; further oncology or gastroenterology follow-up depends on the underlying disease."}}],"indications":["Small bowel tumors (adenocarcinoma, neuroendocrine tumor, GIST, lymphoma, benign tumors)","Crohn's disease strictures or complications refractory to medical therapy","Small bowel obstruction due to adhesions, strictures or non-viable bowel","Bowel ischemia or infarction","Traumatic perforation or injury","Bleeding from small bowel lesions not controlled endoscopically","Perforation or fistula","Complicated Meckel's diverticulum"],"main_risks":["Anastomotic leak","Intra-abdominal abscess or surgical site infection","Postoperative ileus","Bleeding","Adhesions and later bowel obstruction","Short bowel syndrome or malabsorption after extensive resection","Venous thromboembolism","Anesthetic and cardiopulmonary complications","Incisional hernia"],"pain":"Moderate to significant pain in the first several days, managed with multimodal analgesia; laparoscopic surgery is usually less painful than open. Gradual improvement over 1-2 weeks.","preparation":["Blood tests, imaging (CT or MR enterography), anesthesia evaluation","Fasting before surgery per anesthesia instructions","Nutritional optimization and medication review with surgical team","Bowel preparation only if surgeon advises","Smoking cessation where possible","Informed consent, including discussion of possible stoma"],"recovery_timeline":[{"phase":"Hospital stay (days 0-5)","description":"Early mobilization, gradual reintroduction of fluids and diet as bowel function returns, pain control and monitoring for complications.","restrictions":["No driving","Avoid lifting"]},{"phase":"Early home recovery (weeks 1-4)","description":"Fatigue and incisional discomfort improve gradually; diet advanced to normal as tolerated with small frequent meals.","restrictions":["No heavy lifting (about 4-6 weeks)"]},{"phase":"Return to activity (weeks 4-8)","description":"Return to work and gradual resumption of normal activity and exercise.","restrictions":["Avoid strenuous abdominal strain until cleared by the surgeon"]}],"rehabilitation_days":{"min":21,"max":42,"unit":"days","qualifier":"Ordinary functional recovery to routine daily activities after uncomplicated resection; no formal rehabilitation program usually needed."},"result_longevity":"The resection is permanent: removed bowel does not regrow, and the anastomosis heals within weeks. Long-term outcome depends on the underlying disease, such as Crohn's recurrence or tumor follow-up, and on bowel length removed.","revision_rate_pct":{"min":3,"max":8,"unit":"percent","qualifier":"Unplanned return to theatre within 30-90 days, e.g. for leak, bleeding or obstruction."},"scars":"Laparoscopic approach leaves several small scars (about 0.5-1.2 cm) plus a small extraction incision; open surgery leaves a midline or other abdominal scar. Scars fade over months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation in the typical elective uncomplicated case."},"stages":[{"code":"resection_anastomosis","label":"Resection of the diseased bowel segment with primary anastomosis","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed during the single operation."}}],"qualifier":"Staged surgery with a stoma is exceptional and not the typical protocol."},"success":{"metric":"Successful resection with restored bowel continuity, no reoperation","value":93,"unit":"percent of patients","horizon":"30 days after surgery","population":"Adults undergoing elective segmental small bowel resection with primary anastomosis","evidence_status":"limited"},"techniques":[{"name":"Laparoscopic small bowel resection with anastomosis","suits_whom":"Stable patients with localized disease and without extensive adhesions or hostile abdomen.","recovery":"Usually shorter hospital stay and faster return to activity."},{"name":"Open small bowel resection with anastomosis","suits_whom":"Emergencies, extensive adhesions, large tumors, previous multiple surgeries or unstable patients.","recovery":"Longer hospital stay and recovery, larger scar."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1.5,"max":4,"unit":"hours","qualifier":"Operating time for a single uncomplicated segmental resection with anastomosis; longer for extensive or complex disease."},"initial_assessment_documents":["Abdominal CT or MR enterography report","Recent abdominal CT images on disc","Capsule endoscopy or small bowel follow-through report","Biopsy or pathology report","Previous abdominal surgery operative reports","Recent blood test results"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single operation with primary anastomosis; stay 7-14 days including hospital nights and fitness-to-fly check. Follow-up can be local or remote."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team treating you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that you are satisfied with the facilities and standards of the clinic or hospital","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you are clear how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Ask the medical team questions about your 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decision","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell; a lack of information; pressure to make a quick decision","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"No discussion of possible complications","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell; a lack of information; pressure to make a quick decision; no discussion of possible complications","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"No mention of aftercare","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell; a lack of information; pressure to make a quick decision; no discussion of possible complications; no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Bleeding or discharge from surgery site","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24767-laparotomy","host":"my.clevelandclinic.org","quote":"Bleeding or discharge from your surgery site.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Unable to poop or pass gas","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24767-laparotomy","host":"my.clevelandclinic.org","quote":"You can’t poop or pass gas.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Swelling or pain in one 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