Right Hemicolectomy

Learn more about right hemicolectomy at King Edward VII’s Hospital

Why would I need a right hemicolectomy?

Most patients who hemicolectomy surgery have a condition that has caused the right hand side of the large bowel to become diseased, requiring it to be removed. Common conditions requiring surgery include large right sided colon polyps, bowel cancer, Crohn’s disease and certain abnormalities of the appendix.

What symptoms does a right hemicolectomy surgery address?

Right hemicolectomy surgery helps to treat and provide relief from blockages and diseased sections of bowel caused by inflammatory bowel diseases such as Crohn’s disease or bowel cancer.

When should you speak to your specialist about a right hemicolectomy operation?

Right hemicolectomy is usually performed after being referred to a colorectal specialist who will be able to answer all of your questions and talk to you about your recovery.

This kind of surgery is also sometimes carried out in an emergency situation outside of the immediate care of your specialist.

How is a right hemicolectomy performed?

The operation is performed under a general anaesthetic, usually as a keyhole surgery procedure (laparoscopically). Sometimes, open surgery is required to remove the abnormality. You can expect to remain in hospital for between three and seven days afterwards.

A laparoscopic right hemicolectomy involves your surgeon making several small cuts in your abdomen in order to gain access to the diseased part of the large bowel with surgical instruments. The diseased bowel is removed through a small incision around your belly button. Open surgery means that your surgeon will make one long, thin cut down the middle of your abdomen.

With either technique, the right side of the colon is mobilised (freed from the surrounding tissues), the blood supply to it is divided and it is removed. The two remaining ends of bowel (the small intestine and transverse colon) are then joined together with sutures or titanium staples. The bowel is returned to the abdomen and the skin is closed. Very rarely, and usually only in emergency situations, it is not possible to join the two bowel ends together and a temporary stoma (ileostomy) is made, which can be joined to the transverse colon at a later date.

What is the recovery like for right hemicolectomy surgery?

Your recovery from right hemicolectomy surgery will depend on multiple factors, including your age, fitness level and the nature of your procedure.

When you wake from surgery, you will be provided with pain relief which may also include a patient controlled analgesia (PCA) morphine pump. You may be attached to an intravenous drip and have a catheter inserted into your bladder.

Your surgical team will give you advice on when and what you should start to eat. Usually you can drink liquids on the day of surgery and can start a light diet the following day. This may involve soft foods to begin with. They will also advise how much physical activity you should be undertaking every day and when you can start to carry out your normal activities and return to work.

It may be six weeks or so before you can lift anything heavier than 15 kilogrammes and it may take a few months before your abdomen feels normal again. There may also be numbness around the cuts in your abdomen. The bowel function is usually not affected after a right hemicolectomy.

Are there any risks/complications associated with right hemicolectomy surgery?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

Right hemicolectomy surgery has a risk of serious complications. The following risks and complications can occur in a small number of cases:

• Anastomotic leak, where the bowel leaks where it’s been joined back together
• Damage to the bowel or surrounding organs
• Paralysis of the bowel (ileus)
• Chest infection
• Wound infection
• Clots in the legs or lung (you will be given medication to prevent these)

How can I prepare for right hemicolectomy surgery?

Prior to right hemicolectomy surgery, your surgeon will discuss with you how best to prepare for surgery, as each patient is different.

Common preparations for right hemicolectomy surgery include:

• Routine blood tests, x rays or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise
• Taking a carbohydrate loading drink the day before and on the morning of surgery

Your doctor may also ask that you follow a special diet and some surgeons will ask you to take a laxative bowel preparation in the days before surgery in order to clear your bowel.

Are there alternatives for right hemicolectomy surgery?

If your surgeon has recommended right hemicolectomy surgery, it’s unlikely that any other treatment will be suitable for you.