If you're having colon surgery, learn what to expect, the risks and how to prepare.
Colectomy is a surgical procedure to remove all or part of your colon. Your colon, part of your large intestine, is a long tubelike organ at the end of your digestive tract. Colectomy may be necessary to treat or prevent diseases and conditions that affect your colon.
There are various types of colectomy operations:
Colectomy surgery usually requires other procedures to reattach the remaining portions of your digestive system and permit waste to leave your body.
During a partial colectomy, a surgeon removes the diseased portion of your colon and a small portion of surrounding healthy tissue. The surgeon may join the cut ends of the colon so that waste leaves your body normally. Or it might be necessary to connect the colon to an opening (stoma) in the abdominal wall, where waste leaves the body and collects in a bag attached to the opening. A stoma is usually temporary, but is sometimes permanent.
Colectomy is used to treat and prevent diseases and conditions that affect the colon, such as:
Discuss your treatment options with your doctor. In some situations, you may have a choice between various types of colectomy operations. Your doctor can discuss the benefits and risks of each.
The colon is a long tubelike organ in the abdomen. It's the longest part of the large intestine. The colon carries waste to be expelled from the body. The rectum makes up the last several inches of the colon.
Colectomy carries a risk of serious complications. Your risk of complications is based on your general health, the type of colectomy you undergo and the approach your surgeon uses to perform the operation.
In general, complications of colectomy can include:
You'll spend time in the hospital after your colectomy to allow your digestive system to heal. Your health care team will also monitor you for signs of complications from your surgery. You may spend a few days to a week in the hospital, depending on your condition and your situation.
During the days leading up to your colon surgery, your doctor may ask that you:
Preparing for colectomy isn't always possible. For instance, if you need an emergency colectomy due to bowel obstruction or bowel perforation, there may not be time to prepare.
You'll spend at least a few days in the hospital after your colectomy, depending on your situation. Make arrangements for someone to take care of your responsibilities at home and at work.
Think ahead to what you might like to have with you while you're recovering in the hospital. Things you might pack include:
On the day of your surgery, your health care team will take you to a preparation room. Your blood pressure and breathing will be monitored. You may receive an antibiotic medication through a vein in your arm.
You will then be taken to an operating room and positioned on a table. You'll be given a general anesthesia medication to put you in a sleep-like state so that you won't be aware during your operation.
The surgical team will then proceed with your colectomy. Colon surgery may be performed in two ways:
Laparoscopic colectomy. Laparoscopic colectomy, also called minimally invasive colectomy, involves several small incisions in your abdomen. Your surgeon passes a tiny video camera through one incision and special surgical tools through the other incisions.
The surgeon watches a video screen in the operating room as the tools are used to free the colon from the surrounding tissue. The colon is then brought out through a small incision in your abdomen. This allows the surgeon to operate on the colon outside of your body.
Once repairs are made to the colon, the surgeon reinserts the colon through the incision.
The type of operation you undergo depends on your situation and your surgeon's expertise. Laparoscopic colectomy may reduce the pain and recovery time after surgery. But not everyone is a candidate for this procedure. Also, in some situations your operation may begin as a laparoscopic colectomy, but circumstances may force your surgical team to convert to an open colectomy.
Once the colon has been repaired or removed, your surgeon will reconnect your digestive system to allow your body to expel waste. Options may include:
Connecting your intestine to an opening created in your abdomen. The surgeon may attach your colon (colostomy) or small intestine (ileostomy) to an opening created in your abdomen. This allows waste to leave your body through the opening (stoma).
You may wear a bag on the outside of the stoma to collect stool. This can be permanent or temporary.
Connecting your small intestine to your anus. After removing both the colon and the rectum (proctocolectomy), the surgeon may use a portion of your small intestine to create a pouch that is attached to your anus (ileoanal anastomosis). This allows you to expel waste normally, though you may have several watery bowel movements each day.
As part of this procedure, you may undergo a temporary ileostomy.
Your surgeon will discuss your options with you before your operation.
After surgery you'll be taken to a recovery room to be monitored as the anesthesia wears off. Then your health care team will take you to your hospital room to continue your recovery.
You'll stay in the hospital until you regain bowel function. This may take a couple of days to a week.
You may not be able to eat solid foods at first. You might receive liquid nutrition through a vein, often in your arm, and then transition to drinking clear liquids. As your intestines recover, you can eventually add solid foods.
If your surgery involved a colostomy or ileostomy to attach your intestine to the outside of your abdomen, you'll meet with an ostomy nurse who will show you how to care for your stoma. The nurse will explain how to change the ostomy bag that will collect waste.
Once you leave the hospital, expect a couple of weeks of recovery at home. You may feel weak at first, but eventually your strength will return. Ask your doctor when you can expect to get back to your normal routine.
A colectomy procedure to remove one side of the colon is called hemicolectomy. A right hemicolectomy, as shown here, involves removing the right side of the colon and attaching the small intestine to the remaining portion of the colon.