Hemicolectomy is a procedure that involves surgical removal of a portion (right or left) of the colon. The remaining parts are connected with practically little influence on the digestion once the damaged area has been removed. Hemicolectomy is performed to treat, manage or prevent the following conditions:
- Colon cancer
- Crohn's disease
- Bowel cancer
- Ulcerative colitis
- Severe diverticulitis
- Polyps (tissue growth in the colon)
2. Alternate Name
Hemicolectomy is a type of colectomy (surgical colon removal). Left hemicolectomy is also known as open left colectomy, and right hemicolectomy is also known as an open right colectomy. The resection of the sigmoid colon is called sigmoid colectomy.
3. Body Location:
Left hemicolectomy
An open left colectomy is the surgical elimination of descending (left) colon and the fat and lymph nodes around it. It is frequently used to treat malignancies on the left side of the colon. After this, the surgeon connects the transverse colon directly to the rectum.
Right hemicolectomy
The surgical elimination of ascending (right section) colon and the fat and lymph nodes around it is an open right colectomy. After this, the surgeon connects the transverse colon to the small intestine.
4. How Performed
The surgeon will most likely start by creating a few small holes in the abdomen, a procedure known as laparoscopic surgery. In some circumstances, open surgery may be required. This necessitates opening of abdomen.
The surgeon removes the damaged area of the colon after making the incisions. They will also remove any pieces of the intestines that are directly attached to the section of the colon that is being eliminated, like the ending of the smaller intestine or an area of the rectum. Any nodules and blood arteries connected to the colon will also be removed.
If the surgeon cannot reconnect the colon to some other section of the gastrointestinal tract, the colon may be connected to the abdominal wall. This approach could be temporary or permanent, depending on the operation. After the procedure, patients may have to wear a sack on the abdomen to hold the waste, known as a stoma.
Hemicolectomy typically takes two hours, although it might take longer if difficulties arise during the treatment.
5. Preparation
- The time it takes to prepare for a hemicolectomy depends on a person's overall health and any medicines they may be taking.
- Before the operation, a doctor will usually conduct testing to ensure that the patient is a good fit for a hemicolectomy. An electrocardiogram (ECG) and blood tests are among the testing available.
- Before surgery, a person may need to cease taking certain drugs, including blood-thinning medication, for some time. However, they should only stop taking medications if the doctor tells them to.
- Before the surgery, patients must fast for 6-8 hours. They may also require bowel preparation, using a laxative to clear the colon.
6. Procedure Type
Depending on the intensity of cancer or condition, surgical procedure is determined. For example, open surgery is performed for a hemicolectomy when a more extended cut is needed.
The minimal invasive resection of the colon and rectum involves:
- Laparoscopic technique
- Hand-assisted laparoscopic technique
- Single-incision laparoscopic technique
- Robot-assisted techniques
7. Follow up
Regular follow-ups are required to maintain a careful eye on the therapy's progress and in the case of colon malignancies and medical treatment that lasts an extended period.
Due to the elimination of colon tissue, some people report little to no difference in their digestion. Some patients, however, develop cramps or diarrhea as a result of the medication. The doctor will advise them to stay hydrated and eat a bland diet to manage bowel movements.
If the patient is experiencing more frequent diarrhea or stomach pains, their doctor may suggest the following meals to help manage the bowel movements.
8. Risks
The following risks are involved with hemicolectomy:
- Excessive bleeding: There is an increased risk of excessive bleeding after an open hemicolectomy. The doctor may perform a blood transfusion to replenish blood loss in specific instances.
- Infection: Infections can arise during or following any intestinal operation, including a hemicolectomy. Antibiotics are frequently required to treat an infection, which might result in a prolonged hospital stay.
- Colostomy: For certain patients, a colostomy may be required if reattachment of the colon is not possible. The colon is connected to the abdominal wall, creating a stoma.
- Internal injury: The bladder and adjacent organs may be damaged during the surgery. Depending on the amount of the injury, more surgery could be required. Internal injuries might cause healing to be delayed.
9. Recovery
The recovery time for a hemicolectomy varies depending on whether it was performed laparoscopically or openly. However, it is expected that recovery will take 1–2 months.
A person's underlying health condition may hamper recovery. A hemicolectomy with no complications usually necessitates a hospitalization of 7 to 10 days.
A bladder catheter is often left in place for 1–2 days following the treatment to remove bladder waste. To remove fluids, the surgeon may place belly drains.
An epidural inserted into the person's back near the spine is commonly used to provide pain medicine. A care professional may offer oral pain medicines after the epidural has been removed.
The patient may not be able to undertake typical everyday routines for a further three weeks after returning home. For about six weeks, they should avoid lifting any heavy things.
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