Bowel Resection (Colectomy)

A bowel resection is surgery to remove part or all of your large intestine, or colon. Doctors also call it a colectomy. You may need this treatment if you have colon cancer, diverticulitis, or inflammatory bowel disease.

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On this page:

• What Is Bowel Resection?
• Types of Bowel Resection
• What to Expect Before, During, and After Bowel Resection

What Is Bowel Resection?

A bowel resection, or colectomy, is a technique doctors use to remove part or all of your colon.

The colon is the longest part of the large intestine. It absorbs water and nutrients from the food you eat and changes the waste that's left into stool.

If doctors can't treat your severe bowel disease with medicine, a colectomy may be the best way option.

Colectomy is a major surgery.

It requires a long operating time and a lengthy recovery.

A hemicolectomy, where surgeons remove only one side of the colon, is also major surgery.

Types of Bowel Resection

There are many types of bowel resections.

The type of surgery depends on the where the disease is and how severe it is.

What is a hemicolectomy?

It's surgery to remove part of the intestine.

These techniques include:

• Right hemicolectomy. A right colon resection removes the ascending colon, which is the part that travels upward on the right side. It's the first half of your colon.
• Left hemicolectomy. A left colon resection removes the descending colon, the part that travels downward on the left. It's the part near the end of your colon.
• Sigmoid colectomy. This removes the last section of the colon — the part of the colon that meets the rectum.
• Ileocecal resection. This removes the end of the small intestine (ileum).

Hemicolectomy vs. colectomy

A hemicolectomy and a colectomy differ by how much of the colon doctors remove.

A total colectomy removes the whole colon. A hemicolectomy removes part of the colon.

What happens after doctors remove diseased tissue?

There are many options once your doctor removes part of the colon. It depends on how much of the colon they removed, and where that section was.

You may have one of these techniques:

• Anastomosis. Doctors stitch or staple the two healthy ends of the bowel back together.
• Colostomy. Doctors redirect the section of colon that remains to a stoma — a hole in the abdominal wall to empty stool. A colostomy bag outside the body will collect the stool — for a short time or the rest of your life.
• Ileostomy. Doctors redirect the end of the ileum (small intestine) to a stoma. Stool then goes into a colostomy bag. Doctors may do this surgery when they remove the whole colon or a part that's near the small intestine.

How we complete bowel resection at UPMC

At UPMC, we do bowel resection using a few techniques:

• Open surgery. This is standard surgery with a cut of 6 to 8 inches in your belly. Doctors can look right at the organs of your belly. Open surgery may be your only option if you're having emergency surgery.
• Laparoscopic surgery. This method uses smaller cuts to the belly and a thin, lighted tube to let doctors see inside your belly. One pro to a lap colectomy is faster recovery. One example is a laparoscopic right hemicolectomy.
• Robotic surgery. Like laparoscopic surgery, but surgeons control robotic instruments for this method. These techniques allow doctors to be more precise and for you to heal faster. One example is a robotic right colectomy.

Bowel Resection Risks and Complications

Any bowel resection is major surgery and comes with certain risks and complications.

They include:

• Bleeding inside the belly.
• Blood clots in the legs or lungs.
• Damage to other organs.
• Getting a hernia at the surgical site.
• Infection.
• Leaking from the anastomosis.
• Peritonitis, or swelling of the lining of the abdomen.
• Problems with the colostomy.
• Scar tissue forming in the belly and blocking the intestines.
• The suture where doctors sewed your intestines together coming apart.
• The wound breaking open.

Is a Bowel Resection Right for Me?

You may need a bowel resection if you have bowel damage or disease that doesn't respond to medicine.

Conditions We Treat with Bowel Resection

Doctors treat many severe health issues with bowel resection.

They include:

• Abdominal injury.
• Blockage from scar tissue in the intestine.
• Colon cancer.
• Diverticulitis.
• Gastrointestinal bleeding.
• Inflammatory bowel disease (Crohn's disease and ulcerative colitis).
• Large precancerous polyps.

How to Prepare for Bowel Resection

Your doctor will tell you how to get ready for your surgery.

They may suggest:

• If you smoke, try to stop. Smoking slows down healing and raises the risk of issues from surgery.
• Two weeks before the surgery, you may need to stop taking medicines that make your blood thinner. These include aspirin, ibuprofen, and naproxen.
• You'll need to clean your intestines of stool. That may entail a liquid diet and laxatives for a few days.
• Blood and urine tests, x-rays, and EKGs.

What to Expect Before, During, and After Bowel Resection

Your doctor will give you details about your surgery. It's vital to ask any questions you have.

Before

Your doctor will tell you when you need to stop eating and drinking. They may ask you to drink only clear liquids, like broth, juice, and water for a while.

The day of the surgery, arrive at the hospital on time. If your doctor told you to take any medicine, take it with small sips of water.

You'll receive general anesthesia before surgery. That means you'll be asleep during surgery and won't feel anything. You'll have an IV to provide fluid and a catheter to drain urine.

During

The surgery will take 1 to 4 hours. The time frame depends on what kind of surgery you have and how complex it is.

Your doctor will make 1 or more cuts in your belly and remove the damaged or diseased tissue. Next, they'll connect the healthy ends of the bowel or create a stoma. Lastly, they'll close the incisions in your belly.

After

You'll stay in the hospital for 3 to 7 days. If you have any post-op problems, you may need to stay longer.

By the 2nd day, you should be able to drink clear liquids. Your doctor will OK soft food as your bowels begin to work again. They'll want you to move around as soon as you can.

Most people who have colectomies recover fully in about 6 weeks and don't need colostomy bags after surgery. But if you do have one, you should be able to do most of the activities you did before surgery.