Hemicolectomy- Right

Hemicolectomy is a colectomy procedure to eliminate one side of the colon. A right hemicolectomy involves the removal of the right side of the colon for the treatment of colon cancer. The procedure also includes the removal of the cecum, the hepatic fixture, the one-third portion of the transverse colon along with lymph nodes and fats. The purpose of right hemicolectomy surgical treatment is to treat malignant neoplasms present in the right colon.

The colon is the bowel or the large intestine that forms the lower part of the digestive system, ending with the anus and rectum. The operation is performed in two ways- laparoscopic or as an open procedure. Surgeons eliminate diseased lymph nodes and vessels from the part of the bowel and then join the remaining part of the colon with the small intestine. A type of special staples or sutures is used to make this joining.

Usually, there is no need to create a stoma in case of right hemicolectomy procedure. However, in some cases, it is not possible to join the bowel again. Surgeons try to bring the bowel onto the abdomen to create a stoma that creates passage for the waste to get out of the body.

There are certain complications and risks of right hemicolectomy that include infection, bleeding, blood clotting in the lungs, deep vein thrombosis, leak from the anatomosis (the site where the bowel is connected), damage to other organs like the bladder, ureter, and the small intestine. Least to worry, the risks of the operation is less likely to affect you, since a very minimal percentage of people suffer from the surgery.

Before the treatment of right hemicolectomy, there are a few required preparations to be taken:

• The doctor generally restricts certain medications that may, otherwise give rise to complications during the surgery.
• You should stop eating or drinking for several hours before the surgery as instructed by your doctor.
• Take antibiotics as prescribed by your doctor to prevent infection and bacteria found in the colon.
• Take a laxative solution mixed with water to help clear your bowel. You are suggested to drink the solution several hours before the surgery that causes diarrhoea to help clear your bowel.
• Pack a few essentials before the surgery day. This includes packing your slipper, robes, comfortable clothes, books, magazines and a few other important things that you may want to take to the hospital.

On the day of the surgery, you are taken to the preparation room where your breathing and blood pressure are monitored. You may receive antibiotic medication intravenously. After the preparations, you are taken to the operation table where you are administered general anaesthesia. After you fall asleep, doctors start the surgery:

Laparoscopic hemicolectomy surgery- Laparoscopic surgery is also known as minimally invasive colectomy that involves making several incisions in the abdomen. A tiny camera is passed through one incision, while other special instruments are inserted through the other cuts. The surgery is performed with the instruments while watching the operation on a video screen.

The surgeon pulls the colon through one of the incisions for performing the operation on the colon. The extent of resection depends upon the malignant disease and how far it has spread in the surrounding areas of the right colon. An extended right hemicolectomy is required for lesions that are closed to the hepatic fixture. A 30 degree laparoscopic instrument is used for the surgery to ensure full visualizations of the surgical site.

One of the incisions is longer than the others (measuring 8-10 cms) that allow surgeons to help remove the diseased bowel portion. Sometimes, surgeons make take a last moment decision to do an open surgery for better accessibility to the cancerous parts.  

Open right hemicolectomy- If the surgeon feels right about an open surgery over a laparoscopic procedure, he performs by making a large incision in the abdomen. This allows for easier access to the colon and its surrounding tissues or organs. After examining, he cuts out either a portion or the entire colon.

Within 24-48 hours of the surgery, you are given an oxygen mask to be worn round your face. A catheter is connected to the bladder to drain out urine, and a drip is created in the vein to give you liquids. Pain relief medications are given through the drip to help you overcome your uneasiness.

In the following day, you can start having liquids, while solid foods are given to you gradually. The recovery time of right hemicolectomy (laparoscopic) is quicker than an open procedure. The hospital stay varies post surgery ranging from 3-7 days. If complications arise later, you should contact your doctor right away.