A hemicolectomy is a surgery to remove the part of your large intestine called your colon. This procedure is done if your colon has been affected by a condition or has become cancerous.
Your colon can be partially removed without affecting how it works in your digestive system. Once the affected part is removed, the remaining ends are joined together with almost no impact on your digestion.
Some common conditions treated by a hemicolectomy include:
- cancer of your colon
or bowels - trauma or injury to your abdominal area
- inflammatory
bowel disease (IBD), such as ulcerative colitis
or Crohn’s disease - polyps, or tissue
growths in your colon that can become cancerous - diverticulitis,
which happens when diverticula (small pouches) in your colon get infected or inflamed
There are two main kinds of hemicolectomies, left and right.
In a right hemicolectomy, the ascending colon (the part of your colon that’s attached to the end of your small intestine) is removed. Then the small intestine is attached to the transverse colon (the part of your colon that goes across your body).
In a left hemicolectomy, the descending colon is removed. This is the part of your colon that’s attached to your rectum. After it’s removed, the surgeon attaches the transverse colon directly to your rectum.
You’re likely a good candidate for this surgery if you’re otherwise in generally good health, aside from the condition that may need to be treated by a hemicolectomy.
If you have certain conditions, you may have increased risk of complications from the procedure. These conditions include:
- pregnancy
- heart conditions
- bleeding or clotting problems
- scar tissue from previous colon or abdominal
surgery - being overweight or obese
- advanced colon cancer or other types of bowel
cancer
Be sure to talk to your doctor before surgery about the risks if you have any of these conditions.
Before the surgery, you may need a full physical examination. This lets your doctor check for any conditions that could cause complications during surgery. Your doctor will let you know if you’ll need to have a stoma after surgery. This is when the colon is joined directly to your skin. Waste from your bowels then empties into a bag attached to the stoma, known as a colostomy bag.
If you’re taking any medications, ask your doctor if you need to stop taking them before surgery. People generally need to stop taking any blood thinners, such as warfarin (Coumadin) or aspirin. These can increase your risk of complications during surgery.
Your doctor may ask you to take laxatives a few days before your surgery. These help clear out your digestive tract. This step is sometimes called bowel prep. Emptying your intestines can make the procedure easier and reduce your risk of infection.
You may need to fast right before surgery. Your doctor may instruct you not to eat or drink for up to 12 hours before the procedure.
When you arrive
When you arrive for your procedure, you’ll be checked in and brought to a room where you’ll be asked to remove your clothes and put on a hospital gown. Then you’ll lie on an operating bed or table. A doctor will give you general anesthesia, so you won’t be awake for or aware of the rest of the procedure.
Then you’ll be connected to an intravenous (IV) drip to give your body nutrients and to help keep your pain under control. A nasogastric tube will be inserted through your nose into your stomach. A catheter will be inserted into your bladder to drain your urine.
The surgical procedure will begin shortly afterward.
During the surgery
To remove part of your colon, your surgeon will likely begin by making a few small incisions in your abdominal area. This is known as laparoscopic, or keyhole, surgery. In some cases, you may need to have open surgery. This means that the skin and tissue around the colon must be fully opened.
After making the incisions, your surgeon will remove the affected part of your colon. They’ll also remove any parts of your intestines directly connected to the part of your colon being removed, such as the end of the small intestine or part of the rectum. They’ll remove any lymph nodes and blood vessels that are connected to your colon too.
Once the affected part of your colon is removed, your surgeon reconnects the rest of your colon. If your ascending colon was removed, they connect your colon to the end of your small intestine. If your descending colon was removed, they will connect the rest of your colon to your rectum. This rejoining is known as anastomosis.
In the case that your surgeon can’t rejoin your colon to another part of your digestive tract, they may join your colon to your abdominal skin. This is called a stoma, and you may need to wear a bag on your abdomen to store your waste after the surgery. Based on your surgery, this solution may be temporary or permanent.
A hemicolectomy usually takes about two hours, but it may take longer depending on any complications during the procedure.
A hemicolectomy is a major surgery. You may not be able to get back to normal activities for several weeks or more afterward.
When you wake up from surgery, you’ll likely feel groggy from the anesthesia. You won’t feel much pain at first because of the pain medications given to you through an IV drip.
Over the next few days, your doctor will follow up with you. They’ll ask how much pain you feel and how well you can keep food down.
Before you go home from the hospital, your doctor will determine whether you have any infections or complications from surgery. They will need to make sure you can also pass gas and solid waste.
In some cases, you may need to stay in the hospital for one to two weeks to recover enough to go home, especially if you had an open hemicolectomy. Before you go home, your doctor will likely prescribe medications such as ibuprofen (Advil) to help manage your pain and docusate (Colace) to help prevent constipation. Learn more about how to manage constipation after surgery.
Once you’ve returned home, you may not be able to do normal daily activities for another two to three weeks. You also shouldn’t lift any heavy objects for at least six weeks.
Even without a part of your colon, you may not notice any significant changes to your digestion. You may not need to change your diet.
If you notice more frequent diarrhea or stomach cramps, your doctor may recommend some of the following foods to help control your bowel movements:
- applesauce
- bananas
- cheese
- fiber-rich
foods or supplements - oatmeal or cream of wheat
- pasta
- potatoes
- mild teas
- yogurt
Your doctor may also recommend drinking more water or drinks with additional electrolytes, such as Gatorade, to keep you from getting dehydrated.
There are risks associated with anesthesia and with the surgery itself. See your doctor right away if you notice any of the following:
- diarrhea or constipation that lasts for a few
days - fever of 100˚F (37.8˚C) or higher
- irritation or pus around the cuts in your
abdomen - pain in your abdominal area that doesn’t stop with
medication
Other complications can include:
- leakage around the area where your colon was
rejoined - blood
clots in your lungs or legs during or after surgery - infections
- damage to organs surrounding your colon
- blockage in your colon due to scar tissue
After a few months, the incisions will heal and you’ll no longer feel pain in your bowels or abdominal area.
If your hemicolectomy was done to help treat cancer, you may need to follow up with your doctor for chemotherapy or other treatments to make sure that the cancer doesn’t spread.
If you need to wear a colostomy bag for a stoma, your doctor will follow up with you. You can discuss how long you’ll need to wear it and when you can get it removed.
You’ll likely be able to keep your normal diet. You shouldn’t notice any major changes to your bowel movements after a hemicolectomy. But in some cases, you may need to make changes to your diet or lifestyle to make sure that your colon stays healthy.