Hemicolectomy

What is a hemicolectomy?

A hemicolectomy is a surgical procedure to remove a section of the right side or the left side of your colon. Your colon is the largest part of your large intestine, which is in the lower part of your abdomen (belly).

If you have colon cancer, a hemicolectomy may reduce the risk it will spread. If you have a severe form of digestive disease, it can ease your symptoms. But a hemicolectomy can be a life-changing event because it can affect how you poop. Your surgeon may do an ostomy. This is a new opening in your abdominal wall. Your poop goes through the hole into an ostomy bag. Whether it’s temporary or permanent, an ostomy may mean making some changes in your daily activities.

What conditions are treated with hemicolectomies?

Your colorectal surgeon may recommend this surgery if:

• A colonoscopy shows you have precancerous polyps in your colon
• You have an inherited condition that increases your risk for colon cancer, like Lynch syndrome
• There’s a bowel obstruction. Cancerous tumors or abdominal adhesions may block parts of your colon
• You have a severe case of inflammatory bowel disease like Crohn’s disease or ulcerative colitis
• Disease or injury has made a hole in your colon

Types of hemicolectomies

There are two types of hemicolectomies: a right hemicolectomy and a left hemicolectomy.

• Right hemicolectomy: This is surgery to remove your ascending colon. Your ascending colon is about 8 inches long. It’s on the right side of your abdomen. It moves food waste from your small intestine up to your transverse colon.
• Left hemicolectomy: This surgery removes your descending colon. Your descending colon is about 6 inches long. It’s on the left side of your abdomen. It continues the process of turning digested food into poop.

Is a hemicolectomy major surgery?

Yes, it is. Even though most hemicolectomies are minimally invasive, they’re major surgeries because:

• They involve removing part of an organ — in this case, your colon
• You receive general anesthesia
• You need to stay in the hospital for a few days

How should I prepare for a hemicolectomy?

Your care team will explain all the steps you should take before your surgery. Here are some general suggestions:

• Quit smoking. Smoking makes it harder for your body to heal.
• Tell your surgeon what medicines, over-the-counter drugs and supplements you take. They’ll let you know if, and when, you need to stop taking any medications before surgery.
• Plan to stay in the hospital for several days up to a week after your surgery.
• Do bowel prep the day before your surgery.
• Stop eating food at least four hours before your surgery. You can drink clear liquids for up to two hours.

What happens during a hemicolectomy?

Most hemicolectomies are minimally invasive (laparoscopic or robotic) surgeries. Here’s what typically happens during a laparoscopic hemicolectomy:

• You receive general anesthesia, so you’re asleep during surgery.
• Your surgeon will make a small incision in your abdomen.
• They’ll place a laparoscope through the incision. This is a thin rod with a tiny video camera. The camera projects images of your colon onto a video screen.
• Next, they’ll pump gas into your abdomen. The gas inflates your abdomen and gives your surgeon a clear view of the section of your colon that they’ll remove.
• Your surgeon may make a few more small incisions to get to your colon.
• They’ll remove the section of your colon that’s damaged by disease or injury. They’ll also take a small section of healthy colon from either side of the section they remove.
• If you have colon cancer, your surgeon will remove nearby lymph nodes. A pathologist will examine them for cancer.
• Your surgeon will connect the healthy sections of your colon (anastomosis).
• In a right hemicolectomy, your surgeon will connect your remaining colon to the end of your small intestine. In a left hemicolectomy, your colon will connect with your rectum.
• The surgeon may do a colostomy. This procedure creates a path for your poop to leave your body. You may need one if the ends of your colon can’t connect, or your surgeon wants to give your colon a chance to heal.

How long does a hemicolectomy take?

A laparoscopic hemicolectomy typically takes two to three hours to complete. Your care team will update your family and/or friends throughout your surgery.

What happens after a hemicolectomy?

You’ll stay in the hospital for three to four days. While you’re in the hospital, you’ll:

• Receive pain medication as needed: Your care team will gradually reduce pain medication before you leave the hospital.
• Have a liquid or soft diet: A hemicolectomy can affect your body’s ability to digest food. It may cause your large intestine to stop digesting food. You’ll stay on a liquid or soft food diet until you can fart and poop.
• Start moving around: Your care team will likely have you up and walking the day of surgery.
• Receive information on what to do once you’re home: For example, if you have a colostomy, your care team will show you how to take care of it.

What are the benefits of a hemicolectomy?

If you have colon cancer, a hemicolectomy may remove the cancerous tumor. Removing the tumor reduces the risk that cancer will spread and can often cure cancer alone. A hemicolectomy for conditions like irritable bowel disease can ease symptoms.

What are the risks or complications of a hemicolectomy?

Complications after a hemicolectomy may include:

• Anastomotic leak (this is when you have a leak where the separate parts of your colon connect)
• Bleeding
• Blood clots in deep veins in your legs that may travel to your lungs
• Injury to nearby organs, like your small intestine
• Surgical site infection

What is the recovery time?

Everyone’s situation is a bit different. You should be able to do your normal routine within one to two weeks. You should be able to:

• Walk up and down stairs
• Take a shower
• Drive yourself
• Go to work

When should I call my surgeon?

Contact your surgeon if you have:

• Abdominal pain that doesn’t get better with prescribed pain medication
• Chills
• Cough or you feel short of breath
• Fever (over 101 degrees Fahrenheit or 39 degrees Celsius) doesn’t go away
• Nausea and vomiting
• Pus draining from your incision
• Rectal bleeding
• Swollen abdomen

What is an extended right hemicolectomy?

In this procedure, your surgeon removes all of your colon on the right side of your body and some or all of your transverse colon. This is the section of colon that runs along the top of your abdomen. It’s often treatment for cancer in your splenic flexure. This is a tiny bend in your colon.