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What is a Hemicolectomy?

Mary McMahon
Updated May 17, 2024
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A hemicolectomy is a surgical procedure in which approximately half of the colon is removed. This surgery is very serious and accompanied with a risk of major complications, and it is not undertaken lightly. Classically, hemicolectomies are used when the bowel is so damaged or diseased that leaving it in place could threaten the patient's well being. This procedure can be performed by a general surgeon, who may open up a laparotomy incision in the abdomen, or use laparoscopy for a less invasive procedure.

In a right hemicolectomy, the ascending portion of the colon is removed, while a left hemicolectomy involves removal of the descending colon. Reasons for this procedure can include severe trauma, colon cancer, polyps in the colon, inflammatory bowel disease, bowel infarction, and diverticulitis. Usually the surgeon uses medical imaging, including examination of the bowels with a camera, along with patient interviews, to determine whether or not this procedure is indicated.

After the surgeon has removed the bowel, he or she is faced with two choices. In some patients, the portions of the bowel may be reconnected for a complete bowel repair. Other circumstances may call for a colostomy, in which the bowel is provided with an outlet which drains to a colostomy bag. Both options are accompanied with risks and issues, including the risk of infection in the case of a repair of the bowel, and emotional distress for patients with colostomy bags.

Risks of a hemicolectomy can include the usual risks associated with surgery, such as infection, an adverse reaction to anesthesia, and other complications, along with the risk of leakage of fecal material into the abdominal cavity, which can lead to peritonitis. A skilled surgeon can greatly reduce the risks, and patients can help reduce the risks by talking with the surgeon and anesthesiologist before the procedure, and carefully following aftercare instructions after the surgery to increase their chances of healing well.

After a hemicolectomy, a patient usually needs to observe dietary restrictions which are designed to allow the bowel to heal from the traumatic surgery. Patients may also be directed to take antibiotic medications to prevent the onset of infection. In the case of a procedure which has ended in a colostomy, the patient will be given training in working with the colostomy bag, including training on spotting the signs of infection, handling the bag safely, and discussing the medical device with caregivers.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGeek researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon999677 — On Feb 20, 2018

Originally I went to the hospital five years ago for a ruptured aneurysm. During surgery they found my colon was necrotic and another surgeon was called in to give me a left hemi colectomy. Since the surgery I have had almost daily bouts of diarrhea. I take immodium almost every other day. The immodium ususally gives me a day without a bm, but the next day it starts all over again. My MD said I have to live with the problem. The bms start out without pain, but by the third or fourth time my intestines are painful and so is my rectum. Has anyone been given a diet that could possibly help or a medication?

By discographer — On Apr 12, 2012

@simrin-- I'm in the same situation as your friend. I think some spasms, aches and certain vitamin deficiencies do happen after hemicolectomies. But they should improve over time.

It's been six months since I had a left hemicolectomy surgery and my symptoms have been improving slowly. I do occasionally get spasms and I am getting treated for iron and B12 deficiency as well. But my doctor says I'm doing good and it will only get better after this.

If your friend's symptoms are not getting any better even after a year, maybe there could be a complication? I do know that there is a risk of bowel blockage after a hemicolectomy and I'm sure that there are other potential complications too.

By SteamLouis — On Apr 11, 2012

My best friend had a hemicolectomy last year and it's been very hard for her since then. Thankfully she is not dependent on a colostomy bag but is suffering from pain and diarrhea since her operation.

She doesn't eat many foods because they cause her pain and frequent bowel movements. She has lost a lot of weight and last she told me she now has an iron deficiency as well. She's been in and out of the hospital several times and takes pain medication almost daily.

It's so sad to see her this way. She was a healthy, happy woman before this operation. She was forced to have a hemicolectomy surgery because of a rupture in her colon. Her life has changed so dramatically. The physical side effects have been bad and she's also missed a lot of work because of it.

Do all people who have hemicolectomies suffer so much? Won't her condition improve with time and her pain and bowel issues go away? I just want her to be healthy and happy again.

By burcidi — On Apr 11, 2012

@anon205187-- It's not the same thing. That would be called a colectomy because you had a piece of the colon removed, not half of it. If the entire colon is removed or a small part of it (less than half), then it's called a colectomy. A hemicolectomy is only when half of the colon is removed surgically. The prefix "hemi-" means "half" in Latin.

The appendix is actually part of the colon, it's a small pouch like structure at the tip of the large intestine. A right hemicolectomy procedure also includes the removal of the appendix. But there are many cases where only the appendix is removed which is called an "appendectomy."

If I understand correctly, you didn't even have your appendix removed, just the abscess on the appendix. So that is mostly likely labeled as a colectomy.

By anon205187 — On Aug 11, 2011

i had this procedure done for an abscess on the appendix. not sure if that's the same thing.

By anon91412 — On Jun 21, 2010

Has anyone ever heard of this procedure being used for a mucus seal on an appendix?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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