Bowel surgery

What is a colectomy?

Colectomy is a surgical procedure that involves the removal of all, or the partial sectioning, of the large intestine (colon). The colon is a long tube-shaped organ at the end of the digestive tract. A colectomy is necessary to treat or prevent diseases and conditions that affect the colon.

Diseases and conditions treated with a total or partial colectomy

The following conditions may require a colectomy:

• Bowel obstruction – when the colon is blocked.
• Bowel perforation – a torn colon, or where bleeding cannot be controlled.
• Crohn’s disease – removing the affected part of the colon.
• Colon cancer – early-stage cancers may need a small section of the colon to be removed, whilst cancers at a later stage may require more to be removed.
• Lynch Syndrome
• Precancerous colon polyps – those with a high-risk of developing cancer.
• Ulcerative colitis – a colectomy is required if medications are not working.

Different types of colectomy operations

A total colectomy removes the entire large intestine. A partial colectomy, also known as a subtotal colectomy, removes only part of the colon. A hemicolectomy removes either the right or the left portion of the colon and a proctolectomy removes both the colon and the rectum.

Open vs. laparoscopic procedure for colectomy

During an open colectomy, a long incision is made in the wall of the abdomen and doctors can see the colon. In a laparoscopic-assisted colectomy, a lighted tube with a video camera is in inserted through one of several small incisions to guide the surgery.

Risks of a colectomy

The procedure carries a risk of serious complications, which depend on the patients' general health and the type of colectomy used to perform the operation. These complications can include:

• Bleeding
• Deep vein thrombosis (blood clots in the leg)
• Infection
• Injury to organs near your colon, such as the bladder and small intestines
• Pulmonary embolism (blood clots in the lungs)
• Tears in the sutures that reconnect the digestive system.

How to prepare for a colectomy

In the days leading up to the colectomy, the doctor will suggest that the patient stops taking certain medications. Fasting before surgery is also required and drinking a solution such as a laxative that clears your bowels. In some cases, a doctor may prescribe antibiotics to prevent any infection from occurring.