Colectomy

The colon is part of the gastrointestinal, or digestive, system. It’s the portion of the large intestine where digestive waste solidifies into stool, which then moves into the rectum and anus before exiting the body.

When part or all of the colon is diseased, a colectomy may be recommended. Each year, up to 600,000 colectomies are performed in the United States to treat medical conditions affecting the colon, including colorectal cancer and severe cases of inflammatory bowel disease or diverticulitis.

What is a colectomy?

A colectomy, also called colon resection surgery or a large bowel resection, removes the diseased portion of the colon or the entire colon. There are two primary types of colectomy:

• Partial colectomy, also called a “subtotal” colectomy, removes a portion of the colon.
• Total colectomy removes the entire colon, which starts at the end of the small intestine and ends at the rectum.

During a partial colectomy, several inches of the colon are usually removed to fully remove the diseased portion. Partial colectomies are further defined by the portion of the colon that’s removed:

• Hemicolectomy removes one side of the colon, either the left side (the descending colon), which travels downward, or the right side (the ascending colon), which travels upward.
• Sigmoid colectomy removes the bottom section of the colon, known as the sigmoid colon. This portion of the colon connects to the rectum.

If the rectum is also diseased or at risk of disease, a proctocolectomy may be recommended. During this procedure, part or all of the colon is removed, along with the rectum.

After completing a colectomy, a surgeon may be able to rejoin the two ends of the bowel, making the intestines whole again. This is called anastomosis. When it isn’t possible to reconnect the bowel ends, a colostomy may be needed to temporarily or permanently redirect the intestines and allow waste to exit the body.

When is a colectomy needed?

Colectomy may be recommended to treat many different medical conditions, including both acute problems, such as an intestinal blockage, and chronic health issues, such as ulcerative colitis. Colon resection may be used to treat:

• Anal fissures
• Colorectal cancer
• Crohn’s disease
• Diverticulitis
• Intussusception, which causes part of the intestine to push into another
• Familial polyposis, which causes growths on the lining of the colon or rectum
• Gastrointestinal bleeding
• Intestinal blockages
• Precancerous colon polyps
• Ulcerative colitis
• Volvulus, which is a twisting of the bowel
• Colectomy may also be recommended if an injury damages the colon or if there’s a lack of nerve function to the large intestine.

Is robotic colectomy right for me?

Colectomy has traditionally been performed as an open surgery, but that’s changing. Today, many patients undergoing the procedure can have it performed in a minimally invasive way, either laparoscopically or robotically.

Patients undergoing minimally invasive procedures benefit in a number of ways because of the less invasive manner of performing surgery through fewer, smaller incisions. This can include a faster discharge from the hospital, a quicker overall recovery, reduced blood loss, fewer complications, and less pain.

Surgeons at Northeast Georgia Medical Center (NGMC) have specialty training in performing both laparoscopic and robot-assisted procedures, including robotic colectomy. While robotic colectomy isn’t appropriate for every patient, it is an option for many patients.

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