Trans Anal Minimally Invasive Surgery (TAMIS): aftercare advice
Information for patients from Day Surgery
You have had Trans Anal Minimally Invasive Surgery (TAMIS). The following advice is to help you understand what you should do and expect in the days and weeks following your surgery.
When you get home and for the first few days after your surgery
Arrange for someone to collect you from hospital and look after you for the first 24 hours.
You must rest for 24 to 48 hours after your operation.
If you have had a general anaesthetic, avoid drinking alcohol, smoking, or taking sleeping tablets for 24 hours after your operation.
If you have had a general anaesthetic, do not drive, cook, or operate any machinery for 24 to 48 hours after your operation.
What are the risks to having this procedure?
You may have a bit of bleeding from the site for up to two days following your surgery. It almost always stops by itself without further surgery. If this bleeding continues and shows no signs of stopping, we may need to stop the bleeding by carrying out another minor operation.
The raw area in your rectum, where the polyp has been removed, can lead to inflammation around your back passage. This is usually treated with antibiotics and hospital observation, and rarely causes problems. Once discharged from hospital, if you have any of the following you should either see your GP or contact the hospital as soon as possible. These can be signs of an infection developing.
Marked pain in your lower abdomen, back passage, or lower back.
You feel generally unwell.
You may have slight staining in your underwear and seepage of mucus for a few days after your operation. This is not uncommon, and is due to the gentle stretching of the tail end (anus) during your operation. This almost always comes back to normal without any treatment.
It is not always possible to complete the operation using the TAMIS procedure. Very occasionally this means having major surgery to remove the small cancer or polyp. If this is a possibility, you will discuss this with your surgeon before your procedure.
What happens after my operation?
On returning to the ward after your operation, the nurses will perform regular observations to monitor your recovery.
You may have a continuous infusion (a drip) in your arm. We give you fluids through this drip, but we will stop this early and encourage you to eat and drink normally.
You will take oral antibiotics for five days after your operation to reduce your risk of infection.
How will I feel?
After your operation you may feel some rectal discomfort. You should not feel any pain unless the polyp that we removed was very near the anus itself. If you do have any pain or discomfort, please let the nurses know so that they can give you painkillers as needed.
A little bit of bleeding is not unusual for the first few days after your operation. This should not be greater than a little spotting, which you will notice more when having your bowels open for the first time.
It is very important to avoid constipation. Drinking plenty of fluid and eating enough fibre in your diet will help with this. You may wish to soften your stools with Lactulose. This is a mild laxative, which you can buy over-the-counter at the chemist.
Following your operation, rectal function may be disturbed but this should settle over the next few weeks. Because of the size of the instrument that is used during the operation, your anal sphincter muscles may be stretched. This may lead to some leakage or incontinence. You may wish to wear a pad for protection until it returns to normal, as it does in nearly all cases.
When can I resume my normal activities?
Once discharged from hospital you may resume your normal activities as soon as you feel able.
You can have sex as soon as it feels comfortable to do so.
When can I return to work?
We advise you not to work for two weeks after your surgery. If you need a certificate for work, please ask a member of staff before you leave hospital.
When can I drive again?
We advise you not to drive in the first week following your surgery, some people need a little longer. It is important that you are comfortable and able to concentrate clearly. Please check with your insurance company before you drive again. Some insurance policies carry restrictions that vary from individual companies.
Do not drive yourself home from hospital after your surgery. Please arrange for someone to collect you from hospital and take you home.
What if I have any questions or concerns after my surgery?
When you return home, if you notice any of the following symptoms, please contact the colorectal clinical nurse specialists (CNS) via the Cancer Care Line on 01227 868666 for advice.
Persistent nausea (feeling sick) and vomiting.
High temperature.
Increased abdominal (stomach) pain.
Persistent bleeding from your rectum.
Further information
Below are the main support associations, together with other useful sources of information. Remember that, although the internet carries a lot of material, it is not all helpful. For the correct information, you should speak to your specialist nurse. They could also give you information about any local support groups.
Colostomy UK
Telephone: 0800 328 4257
EmailCrohn’s and Colitis UK
Telephone: 0300 222 5700Macmillan Cancer Support
Support Line: 0808 808 00 00Bowel Cancer UK
Telephone: 0207 940 1760
Email
This information has been provided with grateful acknowledgement to West Suffolk NHS Foundation Trust