A hemicolectomy is a surgical procedure to remove a diseased or damaged part of the large intestine and reattach the healthy parts together. It is performed in cases of damage to the intestine because of trauma and/or in colon cancers, intestinal infection, diverticulitis, Crohn’s disease, ulcerative colitis, and growth in the colon. Hemicolectomy can be performed in all age groups.
Alternate Name For Hemicolectomy Surgery
Right or left colectomy
Ascending or descending colon of the large intestine
Hemicolectomy Surgery Procedure
Depending on which part of the intestine is affected, the surgeon will perform a right or a left colectomy accordingly. The ascending colon is removed in a right colectomy. In this, the transverse colon is attached to the small intestine. A left colectomy involves the removal of the descending colon and reattaching the transverse colon to the rectum.
There are two ways of approaching the intestine. One is through laparoscopic surgery, in which a small tube with a tiny camera attached is inserted through a hole to visualize the diseased part of the intestine, and the diseased part is removed by inserting instruments via the hole. Another approach is open surgery, where a large incision is made, and the intestine is removed.
Preparation of Hemicolectomy Surgery
- Medications: Preparation for a hemicolectomy begins by stopping all medications taken after consulting the surgeon.
- Fitness tests: Fitness tests are conducted to ensure pre-and post-operative fitness, which include an electrocardiogram, chest X-ray, blood tests, blood pressure monitoring, and blood sugar level checking. Once deemed fit, you will be admitted to the hospital one to two days prior to the surgery for further preparation.
- Bowel prep: A bowel prep is done with the help of a laxative that clears the bowel completely. The abdominal area will be shaved completely, and the patient will have to wear a hospital gown.
- Fasting: A fasting period of 12 hours before the surgery is necessary.
- Anaesthesia: An anesthesiologist will administer anaesthesia through the spine for pain-free surgery.
Laparoscopic or open surgery
A regular follow-up is necessary after hemicolectomy surgery. Stitch removal is usually done two weeks post-surgery. A dressing is done more often to prevent infection. If indicated, one may need a rehabilitation session with a physiotherapist.
One needs to monitor for signs of infection such as swelling, pain, redness, tenderness, and foul-smelling discharge at the operated site. If any of the signs occur, inform the health professional immediately.
Care must be taken not to overexert oneself during daily activities. General precautions include avoiding lifting, pushing or pulling heavy objects, keeping yourself hydrated, and maintaining a physically-active lifestyle.
Risks For Hemicolectomy Surgery
- Bleeding: There can be excessive bleeding around the operated site during or after surgery which is usually controlled and reversed with blood transfusion.
- Infection: Infection may develop internally or externally around sutures because of improper hygiene and a tendency for infection. Precautionary antibiotics are usually started post-surgery.
- Colostomy: It is a procedure performed to divert the waste products generated in the intestine to a small bag attached outside the body near the abdomen. When the reattachment of healthy tissues to one another is not possible, a colostomy is performed.
- Anastomotic leak: The site of attachment of healthy tissues during surgery may get compromised after surgery, leading to leaks causing life-threatening obstructions.
- Constipation/diarrhea: Some individuals may face difficulty in food digestion after surgery which may be temporary during the rehabilitation phase.
Recovery From Hemicolectomy Surgery
A hospital stay of 3-7 days is required to monitor the individual for any signs and symptoms of distress. A urine catheter is inserted to empty the bladder at regular intervals. One is encouraged to begin walking as soon as possible, which prevents blood clot formation. A dietician will provide you with a diet chart to be followed for 6-8 weeks. A bland diet with adequate fluids is recommended in the initial few days after surgery. Driving and lifting weights should be begun as per the advice of the surgeon.