Colectomy

What is a colectomy?

A colectomy is either the partial removal or total removal of the colon, also known as the large intestine.

 

There are many reasons why a patient may require this type of surgery. Some of these reasons include diverticulitis, inflammatory bowel disease, colon or rectal cancer, polyps, or bleeding that cannot be stopped.

How is a colectomy performed?

There are two methods of surgery for a colectomy, open and laparoscopic.

 

For an open (conventional) surgery, a long incision is made down the middle of the abdomen. If this method is required, the patient recovery time in the hospital is generally longer.

 

A laparoscopic surgery, or minimally invasive, requires the surgeon to uses several incisions with specialized tools. Once inside, the surgery is the exact same as an open surgery, however the recovery period is much faster and usually with less pain associated, as the incision site is much smaller than in an open operation. However in emergent situations the chance of a laparoscopic approach are greatly diminished.

What happens during surgery?

During a laparoscopic surgery, the surgeon places a narrow tube into a small incision in the abdomen measuring less than half an inch. Once inside, Carbon Dioxide is pumped into the abdomen to create space for the surgeon to work. Using a laparoscope, which is a tiny telescope with an attached video camera placed inside the tube, the surgeon works by moving the tube through the organ while projecting a magnified image onto a high definition screen. Multiple tubes may be placed inside the abdomen so that assistants may aid the surgeon.

 

At the site of the removal, the colon is detached from surrounding abdominal walls and organs. Blood vessels which supply only that section of the colon are then sealed off. When the removed portion of the colon is ready to be taken out, one incision site is then enlarged to accommodate removal from the abdomen. The two sides of the remaining colon are then attached to one another with sutures or staples. The same process of removal applies during an open surgery, however, the surgeon is working with one incision site and with traditional handheld instruments.

After Surgery

What happens after surgery?

Immediately following the surgery, a patient is continued on IV to maintain hydration and wheeled to the recovery room where he or she will wake up from anesthesia.
Post-operative pain medication is administered to keep pain at a minimum. The patient can start drinking liquids once bowel function has returned, which could take 3-7 days. Being a major surgery, a patient can expect to be in the hospital anywhere from five to ten days.

What is the recovery time?

Recovery can take up to 6-8 weeks, though normal activity can resume in as little as two to three weeks following surgery.
During the six weeks following the surgery, a low-residue diet is recommended to cut down on the amount of bowel movements. As the intestinal tract heals, normal digestion will resume at varying lengths.

What are the complications that may arise?

A colectomy is regarded as a fairly safe procedure, but like with any operation complications do occur.
Some of the complications that could arise are:
  • A leak where the colon is sewn together
  • Internal bleeding
  • Infection
  • Hernia
  • Blood clot
  • Damage to nearby organs
  • Scar tissue

A patient can minimize the risk for complications by following the guideline for pre and post operation.