A hemicolectomy is a type of colectomy surgery that removes one side of the colon, either the right or left, depending on where the problem is. Although it's considered a major surgery, it can significantly improve long-term outcomes for people with certain digestive conditions. In some cases, individuals may need a temporary or permanent ostomy as part of their recovery, and having access to reliable ostomy supplies and proper care can make a big difference in comfort and healing. Here, we’ll explore important details about hemicolectomy surgery, including why it’s performed, what to expect, and life after recovery.
In this article, you'll learn:
- A hemicolectomy is a major surgery that removes one side of the colon, either the right or left, to treat disease and improve digestive health.
- It’s often recommended for conditions like colon cancer, diverticulitis, inflammatory bowel disease, bowel obstructions, or severe intestinal bleeding.
- The procedure can involve removing either the right or left section of the colon, depending on where the problem is located.
- During surgery, the affected section of the colon is removed, and the healthy parts are reconnected, sometimes requiring a temporary or permanent colostomy.
- Recovery typically involves a short hospital stay, gradual return to eating, and light activity as your body heals.
- While complications like bleeding or infection can occur, they’re closely monitored by your care team.
- Most people recover fully with time, and for those with an ostomy, having reliable ostomy supplies and proper ostomy care ensures a smoother recovery and greater comfort.
Why Would Someone Need a Hemicolectomy?
A hemicolectomy is a surgical procedure to remove either the right or left side of your colon when it's diseased or damaged. It may be done when there's a section of the large intestine that's causing problems or at risk for more severe conditions in order to protect your overall health. This is different from a partial colectomy, which may remove only a small part of your colon that's affected, not the entire right or left side. A total colectomy, on the other hand, is a surgery to remove the entire colon.
In more serious instances, a hemicolectomy is used as a treatment for colon cancer and to reduce the likelihood that the cancer spreads. However, it may also be done to alleviate symptoms of digestive conditions and, in some instances, may result in a colostomy or ileostomy. Some of the most common reasons someone may undergo a hemicolectomy include the following.
Colon Cancer
One of the most common reasons for a hemicolectomy is colorectal cancer. There are different types of colorectal cancers, and they involve the colon and rectum. A hemicolectomy is done to address colon cancer, while rectal cancer requires a different surgery, such as abdominoperineal resection (APR).
When a tumor develops in a specific section of the colon, removing that portion can prevent the cancer from spreading to other parts of the digestive system or the body. Surgeons may also remove nearby lymph nodes during the procedure to check for potential cancer spread, which helps guide further treatment decisions such as chemotherapy or radiation.
In some cases, your doctor may recommend a hemicolectomy if a colonoscopy shows precancerous polyps or you have a condition that increases your risk for colon cancer, such as Lynch syndrome.
Diverticulitis
Another frequent reason is diverticulitis, a condition in which small pouches called diverticula form in the colon and become inflamed or infected. While mild cases can often be treated with antibiotics and dietary changes, severe or recurrent diverticulitis can lead to complications like abscesses or uncontrolled bleeding. In these situations, a hemicolectomy removes the affected section of the colon, reducing the risk of future problems and improving long-term digestive health.
Inflammatory Bowel Disease
Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, can also necessitate a hemicolectomy. Chronic inflammation from these conditions can cause significant damage to the colon, including narrowing, scarring, or persistent bleeding. Removing the diseased section can relieve symptoms and prevent further complications.
Bowel Obstruction or Blockages
In some cases, a hemicolectomy is performed to address bowel obstruction or blockages. These blockages may result from tumors and scar tissue or twisted sections of the colon, which can prevent stool from passing normally and lead to severe pain or other digestive complications. Surgery can help restore the flow through the digestive tract and prevent further health risks.
Severe Intestinal Bleeding or Trauma
Lastly, though less common, a hemicolectomy may be required due to severe intestinal bleeding or trauma. When bleeding cannot be controlled or the colon is significantly damaged, removing the affected portion is the safest way to stabilize the patient and restore proper function.
What's the Difference Between a Right vs. Left Hemicolectomy?
A hemicolectomy can involve removing either the right side or the left side of the colon, depending on which section is affected by disease. The distinction is important because each type of surgery targets different parts of the large intestine and may address various medical conditions.
Right Hemicolectomy
A right hemicolectomy involves removing the ascending colon, which is the first part of the large intestine on the right side of the abdomen. In some cases, part of the cecum and a small portion of the small intestine may also be removed, along with your appendix or part of your transverse colon. After removal, the remaining parts of the colon are reconnected, restoring the normal flow of digestive contents.
Left Hemicolectomy
A left hemicolectomy, on the other hand, removes the descending colon, located on the left side of the abdomen. It may also include part of the transverse or sigmoid colon, depending on the condition. Like the right hemicolectomy, the healthy ends of the colon are reconnected, and in some cases, a temporary colostomy may be needed to allow healing. This means that waste will pass through a stoma and into an ostomy bag instead of through the rectum.
What Happens During a Hemicolectomy?
Although many hemicolectomies can be done through minimally invasive techniques, they're still considered a major procedure. The surgery removes a portion of the colon, which carries a risk of potential complications and requires you to stay in the hospital for a few days post-op.
Before your operation date, your care team will discuss what you'll need to do to prepare. This is fairly similar to other surgical treatments in that you should try to quit smoking, stop taking certain medications, do a pre-op fast, and plan to stay in the hospital for up to a week. Your surgeon may also have you prepare your bowel, and will provide specific instructions for how to do this.
On the day of the operation, the procedure begins with general anesthesia, so you'll be fully asleep. Your doctor will likely perform minimally invasive surgery, either laparoscopic or robotic. Both of these involve making a small incision at the surgical site and utilizing tools to help ensure that either side of the colon is removed. Once the section of the colon that's diseased or damaged is removed, your surgeon will reconnect the healthy parts, which is known as anastomosis. If a colostomy is necessary, it will also be done at this point. After, your surgeon will close the incision site. The entire procedure typically takes about two to three hours.
If you have a more complicated case, your surgeon may need to perform open surgery. This requires a larger incision in the abdominal wall so your surgeon can access the colon directly. This allows them to work with a clearer view, which can be helpful in complex cases. Your care team will discuss the details of your case before surgery so you know what to expect.
Recovery After Hemicolectomy
Undergoing any colorectal surgery will require you to stay in the hospital for three to four days, more if there are complications. You'll receive pain medication as necessary and be placed on a liquid or soft diet as your body adjusts to the changes in your digestive tract. During your stay in the hospital, your care team will likely have you start walking around or performing light movements to help reduce the risk of complications. You'll also receive information on how to continue your care at home, depending on your case. This is essential, as doing so will help reduce the risk of complications or further problems.
Possible Risks and Complications
As with any major surgery, there are a few risks and complications. Most notably, these include:
- Bleeding
- Infection
- Injury to nearby organs
- Deep vein thrombosis (blood clots in the legs)
- Pulmonary embolism (blood clot in the lungs)
- Anastomotic leak (a leak where the parts of the colon were reconnected)
If you notice any issues after your procedure, don't hesitate to contact your doctor or go to the emergency room.
Life After a Hemicolectomy
Since a hemicolectomy is a procedure that involves removing a part of the colon, it can take some time to adjust. Your surgeon will provide you with detailed instructions on what to expect, along with some tips for recovery, which may include:
- Most people start with liquids, then slowly transition to soft foods before returning to a normal diet.
- It’s common to experience more frequent or looser stools at first. Your bowel function typically stabilizes over time.
- Gentle walking is encouraged soon after surgery to promote circulation and prevent blood clots, but heavy lifting should be avoided until cleared by your doctor.
- Mild to moderate discomfort is normal in the first few weeks and can be managed with prescribed medications.
- Regular appointments help your surgeon track your recovery and check for any complications.
- Some people may have a temporary or permanent ostomy after surgery. Learning proper ostomy care and having access to reliable ostomy supplies are key to staying comfortable and confident during recovery.
- Eating smaller, more frequent meals and staying hydrated can support healing and help regulate digestion.
Remember, a hemicolectomy is often a life-changing procedure that can help you recover from serious conditions and lead a healthier, more comfortable life. With proper medical care and a strong recovery plan, most people regain normal bowel function and resume their usual routines within weeks. For those who may need an ostomy, Byram Healthcare carries a number of high-quality ostomy products to help improve comfort and quality of life. Contact us today to learn more.
